Clinical Characteristics of Male Patients With Schizophrenia Referred for Forensic Psychiatric Evaluation

Objectives: This study aimed to investigate the sociodemographic, clinical, and offense-related characteristics of male patients with schizophrenia referred for forensic psychiatric evaluation in Korea.Methods: We retrospectively reviewed the records of 129 male patients diagnosed with schizophrenia who underwent forensic psychiatric evaluation at the National Forensic Psychiatric Hospital between January 2022 and December 2024. Sociodemographic, clinical, and offense-related variables were collected from forensic psychiatric evaluation reports and medical records. Patients were further classified into pre-onset and post-onset offense groups according to whether the first offense occurred before or after the onset of schizophrenia.Results: The median age was 48.0 years, and the median education duration was 12.0 years. Most patients were never married (80.6%), and more than half were living alone or homeless. Recurrent hospitalization was common, and 80.3% were not under appropriate treatment at the time of the offense. Physical violence was the most frequent offense type (38.8%), and strangers were the most common victims (66.7%). Compared with the post-onset offense group, the pre-onset offense group was older, had lower education, later age at onset, and more unstable residential status and childhood family structure.Conclusion: Male patients with schizophrenia referred for forensic psychiatric evaluation showed marked social vulnerability, treatment discontinuity, and distinctive offense-related features. The temporal relationship between illness onset and offending may help identify clinically meaningful subgroups for forensic assessment and preventive intervention.