[Concepts in the assessment of "other severe psychological deviance"]

Rendering an expert opinion on offenders with personality disorders is one of the most frequent tasks in forensic psychiatry. In Germany, the juridical term "severe mental deviance" for impaired responsibility, caused by severe personality disorder or sexual perversion, causes a lot of problems, because there is no obligatory psychiatric interpretation of this term. This paper gives a review of the different clinical transpositions by German forensic psychiatrists and discusses the model of "progredient psychopathological development." Based on the common elements of these solutions, the paper proposes a clinical interpretation of "severe mental deviance", which is derived from the diagnostic and clinical practice with non-delinquent patients with severe personality disorders.