認知症における犯罪的思考(Criminal minds in dementia)

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2025-09-01 マックス・プランク研究所

MPI‑CBSのMatthias Schroeterらによるメタ解析では、認知症患者における“犯罪リスク行動(CB)”の発症頻度を多様な症候群で比較。約236,360名を対象とした14研究を定量的に統合し、行動変異型前頭側頭型認知症(bvFTD)では50%以上、意味変異型進行性失語症(svPPA)では約40%と最も高かった。一方、血管性認知症やハンチントン病では約15%、アルツハイマー病では約10%、パーキンソン症候群は10%未満と低い傾向にあった。興味深いのは、これらの行動は認知症が診断される前の初期段階に顕著であり、診断後には一般人口より低下すること。男性においてCBが多く、bvFTDでは認知抑制の喪失(disinhibition)に関連する側頭葉の萎縮が観察された。研究者は、“中年で初めてCBが現れた場合、早期の認知症を疑うサイン”として強調。また、法制度や臨床現場における対応の必要性を指摘している。

認知症における犯罪的思考(Criminal minds in dementia)Persons exhibiting criminal behavior showed larger atrophy in the temporal lobe. © MPI CBS

<関連情報>

認知症における犯罪的思考:系統的レビューと定量的メタ分析 Criminal minds in dementia: A systematic review and quantitative meta-analysis

Matthias L. Schroeter,Marija Žuvela & Lena Szabo
Translational Psychiatry  Published:28 August 2025
DOI:https://doi.org/10.1038/s41398-025-03523-z

Abstract

Introduction

Subjects with dementia might exhibit criminal risk behavior (CB), even in early disease stages.

Methods

This systematic review and quantitative meta-analysis investigated CB prevalence across all neurodegenerative syndromes according to PRISMA criteria and preregistered in PROSPERO. Mean frequencies and odds ratios were calculated and compared.

Results

Finally, the meta-analysis included 14 studies with 236,360 persons. Studies originated from different countries, with largest contributing country being the U.S.A., followed by Scandinavian countries, i.e., Sweden and Finland, and additionally Germany and Japan. All quantitative analyses revealed a very consistent picture: CB prevalence was highest in behavioral variant frontotemporal dementia ( >50%), followed by semantic variant primary progressive aphasia (40%), but rather low in vascular dementia and Huntington’s disease (15%), Alzheimer’s disease (10%), lowest in Parkinsonian syndromes ( <10%). The systematic literature review revealed that CB prevalence is more frequent in early disease course than in the general population, but declines thereafter below population levels. Men are overrepresented.

Discussion

CB is a common symptom in dementia, most pronounced in frontotemporal dementia. CB committed for the first time at mid-age could be an indicator of incident dementia, requiring earliest diagnosis and therapy. As present studies show a wide variability in assessment methods and cohorts investigated, and had been conducted in a minority of countries world-wide, large prospective international studies are warranted that systematically apply homogeneous methods and standardized questionnaires in assessing criminal risk behavior in different dementia syndromes.

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