To define treatment adherence and criminal history before and after the mandatory treatment of homicidal patients and_correlation of these variables with the severity of the criminal act.

160 of the 197 cases, we could be able to contact and who were released from the forensic psychiatry clinic of the Bakirkoy Training and Research Hospital for Psychiatric and Neurological Diseases after mandatory inpatient treatment in 2006 were investigated for treatment adherence and criminal history for five years after release. Criminal Violence Rating Scale is used.

30% of the 48 patients who committed homicidal acts, had criminal history prior to the mandatory treatment and these were usually severe violent criminal offenses targeting directly at the victim's life and 14,5 % of them committed more than a criminal act before the homicidal act. After the mandatory inpatient treatment, the homicidal offenders were more likely to be kept in the mandatory outpatient treatment programme in comparison to the non-homicidal patients (87,6 % and 64,3 % respectively). 41,7 % of the homicidal offenders had been rehospitalized. Mean duration of mandatory treatment was 510 days and 148 days for the homicidal and non-homicidal patients respectively.

The number of criminal offences and number of re-hospitalizations were not significantly different between the homicidal and nonhomicidal patient groups. As a consequence of risk reduction strategies the homicidal patients were internalized longer in terms of mandatory treatment and after the release, their control assessments were done at shorter intervals.