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J Am Acad Psychiatry Law 33:2:188-195 (2005)
Copyright © 2005 by the American Academy of Psychiatry and the Law.
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Gender Differences in Criminality: Bipolar Disorder with Co-occurring Substance Abuse

Susan Hatters Friedman, MD, Melvin D. Shelton, MD, PhD, Omar Elhaj, MD, Erik A. Youngstrom, PhD, Daniel J. Rapport, MD, Kristene A. Packer, BA, Sarah R. Bilali, MA, Kelly Sak Jackson, MA, Heather E. Sakai, MSSA, Phillip J. Resnick, MD, Robert L. Findling, MD and Joseph R. Calabrese, MD

Dr. Friedman is a Fellow in Forensic Psychiatry, Dr. Shelton is Director, Clinical Trials and Electro-Convulsive Therapy, Dr. Elhaj is a Senior Fellow in Psychiatric Research, Ms. Bilali is Research Operations Manager, Drs. Resnick and Calabrese are Professors of Psychiatry, and Dr. Findling is Professor of Psychiatry and Pediatrics, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, OH. Dr. Youngstrom is Associate Professor of Psychology, Psychiatry, & Management, Case Western Reserve University, Cleveland, OH. At the time of the study, Dr. Rapport was Moods Clinical Director, Ms. Packer was Research Operations Manager, Ms. Jackson was Research Coordinator/Research Operations Manager, and Ms. Sakai was Research Coordinator, Case Western Reserve University/University Hospitals of Cleveland. The research was supported by Grant NIMH P20 66054 and a supplement to NIMH R01 50165, 1 C76 HF 00502-01. Address correspondence to: Susan Hatters Friedman, MD, Department of Psychiatry, University Hospitals of Cleveland, Hanna Pavilion, 11100 Euclid Avenue, Cleveland, OH 44106. E-mail: susan.hatters-friedman{at}uhhs.com

Outpatient interviews to collect criminal history data were conducted with 55 women and 77 men who had the dual diagnosis of rapid-cycling bipolar disorder with co-morbid substance abuse disorders (DD-RCBD), to ascertain gender-related similarities and differences. Fifty-three percent of women and 79 percent of men reported that they had been charged with a crime, and nearly half of those charged had been incarcerated. Men with DD-RCBD were more likely to have committed a felony and had a trend of committing more misdemeanors. Although women with DD-RCBD were less likely to have a criminal history than their male counterparts, they were far more likely to have a criminal history than were women in the general population. Implications from this pilot study include the need for earlier identification of bipolar disorder and for the increased availability of psychiatric and substance abuse services within correctional facilities.




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