Schizophrenia in the draft of the ICD-11 and implications for the assessment of criminal responsibility

Abstract

The postulated changes to the classification of schizophrenic psychosis in the announced revision of the ICD (International Classification of Diseases) do not mean a fundamental change to the known concepts. The assessment of the psychiatric prerequisites for criminal responsibility is hardly influenced. The abandonment of subtypes of schizophrenia, however, is possibly associated with a loss of professional knowledge about special and individual courses of schizophrenic psychoses. This is particularly problematic in cases in which the psychotic illness does not result in the widely known phenomenon paranoid-hallucinatory syndrome, but rather with behavioral problems or affect abnormalities, i.e. the hebephrenic courses. Forensic psychiatry is required to actively promote knowledge of such processes in order to adequately identify juvenile offenders (in whom psychopathology is intertwined with normal peculiarities of development) as mentally disturbed in the sense of §§ 20 and 21 StGB and to ensure their proper forensic psychiatric assessment.