It was performed a population study of male patients with schizophrenia, who had committed especially socially dangerous acts (SDAs) against human life and health (AHL) (511 patients) with productive-psychotic (P-P) (251 persons), negative-personality (N-P) (127 persons) and mixed (112 persons) mechanisms of realization (MR) of delict. In this work, on the base of a comprehensive evaluation of clinical-psychopathological, personality-psychological, social-psychological, and criminogenic predictors of a social danger of patients with schizophrenia who had committed SDAs AHL, their prognostic significance was determined, a methodology of a rehabilitative diagnosis and differentiated patients-based therapeutic-rehabilitative programs were worked out taking into account the mechanism of commitment of the delict. This is an effective prevention for second SDAs. It was found out, that in P-P MR SDAs were connected closely with a formation of a persecution systematized delusional and emotionally driven thoughts, which increased SDA risk due to disguise with negative symptoms and an impulsive behavior. In N-T MR of SDAs, criminal activities of a person were based on an emotional-character defect, an inversion of moral motivations, substance addiction; they were manifested under conditions of complete and incomplete remission as well as if a decompensation of asthenic or emotional-flattened variants of psychopathic-like defect of personality occurred. In the process of evaluation of a social danger of the examined persons by means of a comparative analysis of present components of legal and medical criteria of incompetence, it was found out that above mentioned groups were different from each other in terms of significant differentiate markers, which characterized a course of the pathological process and a behavior in circumstances of coercive medical measures (CMM). Integrative differentiated patient-based therapeutic-rehabilitative programs for patients with schizophrenia, who committed SDAs AHL, were scientifically grounded, developed, and implemented. These programs are being implemented in four stages (initial, active interventions, supportive measures, and final stage). The programs are differentiated on a psychopathological mechanism of SDA realization, their basic means is an integral psychopharmacotherapy with potentiation of its effects with patient-based therapy and various kinds of rehabilitative interventions (psychoeducation, motivation training, communication training, leisure, cognitive-behavioral therapy, art-therapy, training of social skills, participation in groups of self-help, physical therapy, various forms of physical trainings as well). An implementation of these programs into a forensic psychiatry practice has achieved reduction (or positive dynamics) of psychopathological symptoms, a decrease in a social danger of incompetent persons with schizophrenia who committed particularly serious offences, an increase in positive responses to CMM. Along with this, a level of a general social functioning has improved by 72.00 % in the main group (by 44.00 % in the control group, р <0.05), a levels of conflict, aggressive, over-active behaviors have decreased by 69.00 % (by 33.00 % in the control group, р <0.05), and level of dysfunction in self-care has decreased by 67.00 % (by 33.00 % in the control group, р <0.01).
