Gender differences in diagnoses of mentally disordered offenders

We investigated differences in psychiatric diagnoses and medicolegal insanity decisions between female and male forensic psychiatric patients. Data on all offenders (N = 4396) subjected to a court-ordered forensic psychiatric inpatient evaluation were obtained for the years 1992–2000. A significantly higher proportion of female mentally disordered offenders were given a diagnosis of personality disorder while mentally disordered male offenders more often had a diagnosis of alcohol and/or drug dependence or sexual disorders. There was an increased likelihood that violent women would be declared legally insane even after controlling for a number of potential confounders. This may reflect an underlying difference in the severity of psychiatric morbidity not accounted for diagnostically or that a gender bias exists in the forensic psychiatric evaluation process. © 2009 International Association of Forensic Mental Health Services.