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A Study of Geriatric Forensic Evaluees: Who Are the Violent Elderly?

Dr. Lewis is Associate Professor of Psychiatry at University of Connecticut Health Center, Farmington, CT. At the time of the study, Dr. Fields was a fourth-year medical student at University of Connecticut Health Center and Dr. Rainey was a fourth-year medical student at University of South Carolina School of Medicine, Columbia, SC. Presented in part at the Annual Meeting of the American Academy of Psychiatry and the Law, Baltimore, October 1999. Supported by Grant NIH5K12-HD01409-04 from Interdisciplinary Research on Women's Health, University of Connecticut Health Center. Address correspondence to: Catherine F. Lewis, MD, 263 Farmington Avenue, Farmington, CT 06030-2103. E-mail: lewis{at}psychiatry.uchc.edu

The objective of this study was to examine a sample (n = 99) of elderly forensic evaluees to describe the psychiatric, medical, legal, and demographic characteristics of the sample and to examine which of these factors is associated with violent charges. Clinical data were gathered through retrospective chart review of patients aged 60 and over who were referred for criminal responsibility/competency-to-stand-trial evaluations from 1991 to 1998 at William S. Hall Psychiatric Institute in Columbia, South Carolina. Most (67.7%) of the sample was alcohol dependent, nearly one half (44.4%) had dementia, and close to one third (32.3%) had antisocial personality disorder. The majority of patients (60.6%) were facing violent charges and most (80.8%) were recidivists. In multivariate analysis, race, outpatient treatment status, crime location, and paranoia were all associated with violent charges. The implications and limitations of these data as applied to forensic treatment settings are discussed.

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