When I finished reading "Sexual Offenders With Mental Issues: Special Considerations for a Special Population," (Psychiatric Times, September 2007) I could hardly believe that Dr Rotter had not mentioned genetics! This is infinitely more important than whether sexual offenders are mentally ill! A genetic basis tells us "what to do about individuals who have been convicted of sexual crimes," and unequivocally supports that "over the past decade, we have witnessed initiatives that require sexual offenders to register with local and state criminal justice agencies, which can restrict sexual offenders from living in large geographic areas and leads to the civil commitment of sexual offenders upon release from prison (the latter is of greatest relevance for mental health practitioners)."
If a mental illness is diagnosed it also will have genetic determinants, so it is abundantly clear, even if it was not previously, that there is an overwhelming urgency for the development of gene therapy in all of medicine, as well as in the other areas.
Mary N. Smith, MD
Dr Rotter responds:
While genetics and many other factors are relevant in the understanding of the etiology of sexual offending behavior, our work in this area is the identification of needs peculiar to persons with mental illness who also offend sexually. I do hope that genetics will ultimately help us in the identification and treatment of all illnesses, including mental illnesses and associated behavior. At this point, such work is at the level of basic science, not clinical assessment and treatment, which was the focus of the article.
Merrill Rotter, MD