Criminal offenders have a high rate of personality disorders (PDS), especially Antisocial Personality Disorders and psychopathy, but criminal acts are not necessarily the result of PD. Findings from psychiatric research suggest that the development of PD is influenced by genetic factors, that can result in deviant traits in temper, emotionality and cognitive style. There is general agreement that those peculiarities and vulnerabilities find their expression and structure only under a complex interplay of stimulating or impairing environmental influences. Do these genetic factors-or other factors-diminish a person's criminal responsibility? There is no difficulty in diagnosing PDs, but the challenging questions arise in forensic assessments of defendants for criminal responsibility who have a PD. This article discusses the German legal situation and special problems created by the term of "diminished" criminal responsibility. In contrast to the Anglo-American legal situation, the German criminal law obliges the court to order an indeterminate forensic - psychiatric confinement, in addition to punishment, if the offender had acted under diminished criminal responsibility and is now still considered to be dangerous. The convicted offender remains under the control of the criminal court during psychiatric hospitalization. The change from handling the personality disordered offender as a criminal to handling him as someone with a mental disorder creates a social option for extended state interventions, including indeterminate hospitalization.

A prospective multidimensional study with 71 remitted bipolar outpatients (37 bipolars without, 34 with psychotic symptoms during acute mania) was made to assess relevant influential factors on relapse and readmission to hospital: characteristic data of previous course, psycho(patho)logical state and personality after remission, personality disorders, and ways of coping. In the course of the 5 years after the first examination, 48% of the patients were readmitted, 60% of them because of a (schizo)manic state. The study confirms the prognostic relevance of past course, e.g. number of previous episodes and mania-quotient. A further risk-factor are residual psychopathological alterations which persist after remission ("negative symptoms" of strictly bipolars, increased vulnerability for dynamic derailment for the bipolars with psychotic symptoms). Patients with "syntonic" personality in the free interval suffered less relapses. The relevance of other personality traits differed in the diagnostic subgroups of nonpsychotic and psychotic bipolars. Active coping was positively correlated with staying healthy, but the correlations were weak.

In a longitudinal survey of 122 healthy criminal offenders aged 18 to 37 years, the relationship between intelligence measured by the Wechsler Adult Intelligence Scale (WAIS), neuropsychological scales and delinquency was investigated. The Benton Test correlates well with the WAIS and moderately with offence data, but not with recidivism in delinquency. The 122 men had normal intelligence test scores (average IQ = 102), but bad school and working records. The 34 per cent and 60 per cent respectively of offenders, who relapsed within the time span of 1.5 and 3 years respectively, showed significantly worse results in the Verbal Scale and in the Block Design of the Wechsler Intelligence Scale. Poor performance in the Information and the Block Design sub-tests of the WAIS, a low level of formal education and the belief in external control by circumstances and powerful others are predictors of a high risk of recidivism.

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