Psychotic symptoms among male adolescent detainees in The Netherlands

This study investigated the prevalence of psychotic symptoms among incarcerated boys as well as the relationship between these symptoms and violent offending and criminal recidivism. The presence of psychotic symptoms was assessed in a representative sample of 204 incarcerated boys aged 12-18 using the Diagnostic Interview Schedule for Children (DISC-2.3). Seventy-two percent of the study participants had committed a violent index offense and 30 percent were criminal recidivists. Thirty-four percent (95% confidence interval [CI]: 27-41%) were DISC-2.3 psychosis screen positive: 25% (95% CI: 19-31%) reported at least one pathognomonic of schizophrenia symptom and 9% (95% CI: 6-14%) reported at least three non-pathognomonic psychotic symptoms. In addition, 33 percent (95% CI: 26-40%) reported one or two isolated, atypical psychotic symptoms. The presence of psychotic symptoms was not associated with violent offending or criminal recidivism. The high prevalence rate of psychotic symptoms among incarcerated boys calls for increased attention to diagnosis and treatment of psychosis. To obtain conclusive answers regarding the relationship between psychosis and violent offending, additional studies are needed in general population samples.