Paraphilia-related disorders and personality disorders in sexual homicide perpetrators

We investigated the relationship between paraphilias (PA), paraphilia-related disorders (PRD), and personality disorders retrospectively in a sample of 161 sexual murderers. Four groups were compared: (1) sexual murderers without a PA or a PRD diagnosis (n=47), (2) sexual murderers with at least one PRD but no PA (n=29), (3) murderers with at least one PA but no PRDs (n=29), and finally, (4) those with a combination of both (PA + PRD, n=56). The PA + PRD group showed a significantly higher prevalence for antisocial (42.9%) and sadistic (32.1%) personality disorders compared to the three other groups. Schizoid personality disorder was more often diagnosed in the two paraphilic diagnosed subgroups (PA = 24.1%; PA + PRD = 24.9%). Our data suggests that PRDs and personality disorders should be systematically assessed in sexual offenders, and that the combination of PAs and PRDs in sexual offenders may characterize a group who are more impulsive, consistent with personality disorders such as antisocial personality disorder.