Homicides by offenders with psychotic illness in Italy and Turkiye: A comparison of offender and crime-scene profiles

Objective: The primary aim of this study was to conduct a comparative analysis of homicide cases and their perpetrators with psychotic illnesses in Italy and Turkiye, identifying the extent to which country-specific factors influence offender profiles and crime-scene characteristics. Method: This cross-national chart review study recruited individuals with psychotic illnesses from forensic psychiatric centers in Italy and Turkiye who were referred for criminal responsibility assessments. Data were collected on the offenders' background characteristics, psychiatric history, victim profiles, and crime-scene details. Results: Compared to the Italian sample, a higher prevalence of hospitalizations, contact with mental health services, and past offending history prior to the index homicide in the Turkish sample highlight inadequate community mental health care and monitoring systems, as well as insufficient supervision by the criminal justice system in Turkiye. Turkish offenders were less likely to exhibit organized crime scenes and post-crime behavior, with fewer stressors preceding the offense, suggesting a greater role of positive psychotic symptoms in their homicidal acts. Conclusion: Despite certain similarities, the differences between the two samples highlight the impact of sociocultural, healthcare, and legal systems on offender profiles and crime-scene characteristics. These findings emphasize the need for tailored mental health services, forensic psychiatric assessments and legal supervision that take into account country-specific factors.