@article{ref1,
title="Increased frequency of brain pathology in inmates of a high-security forensic institution: a qualitative CT and MRI scan study",
journal="European archives of psychiatry and clinical neuroscience",
year="2015",
author="Witzel, Joachim G. and Bogerts, Bernhard and Schiltz, Kolja",
volume="266",
number="6",
pages="533-541",
abstract="This study aimed to assess whether brain pathology might be more abundant in forensic inpatients in a high-security setting than in non-criminal individuals. By using a previously used reliable approach, we explored the frequency and extent of brain pathology in a large group of institutionalized offenders who had not previously been considered to be suffering from structural brain damage and compare it to healthy, non-offending subjects. MRI and CT brain scans from 148 male inpatients of a high-security mental health institution (offense type: 51 sex, 80 violent, 9 arson, and 8 nonviolent) that were obtained due to headache, vertigo, or psychological complaints during imprisonment were assessed and compared to 52 non-criminal healthy controls. Brain scans were assessed qualitatively with respect to evidence of structural brain damage. Each case received a semiquantitative rating of &quot;normal&quot; (=0), &quot;questionably abnormal&quot; (=1), or &quot;definitely abnormal&quot; (=2) for the lateral ventricles, frontal/parietal cortex, and medial temporal structures bilaterally as well as third ventricle. Forensic inpatients displayed signs of brain damage to a significantly higher degree than healthy controls (p < 0.001). Even after adjustment for age, in the patients, being younger than the controls (p < 0.05), every offender type group displayed a higher proportion of subjects with brain regions categorized as definitely abnormal than the non-criminal controls. Within the forensic inpatients, offense type groups did not significantly differ in brain pathology. The astonishingly high prevalence of brain pathology in institutionalized inmates of a high-security mental health institution who previously had not been considered to be suffering from an organic brain syndrome raises questions on whether such neuroradiological assessment might be considered as a routine procedure in newly admitted patients. Furthermore, it highlights that organic changes, detectable under clinical routine conditions, may play a role in the development of legally relevant behavioral disturbances which might be underestimated.<p /> <p>Language: en</p>",
language="en",
issn="0940-1334",
doi="10.1007/s00406-015-0620-2",
url="http://dx.doi.org/10.1007/s00406-015-0620-2"
}