[School shootings by adult outsiders ­ psychiatric aspects and risk markers]. / Amokläufe an Schulen durch Außenstehende - Psychiatrische Auffälligkeiten und Risikomarker.

Objective: Three cases of rampage killings at German schools by adult outsiders were identified and analyzed. The cases took place between 1913 and 1983. To what extent do psychiatric aspects play a role and are there risk factors that can be identified und used for prevention? Method: For the identification of risk factors the warning behavior typology was utilized which covers eight behavioral factors. Results: Severe mental problems were found in all three cases. The factors of the warning behavior typology were present in different relevance: Pathway (100 %), Fixation (100 %), Identification (33 %), novel aggression (33 %), energy burst (33 %), Leakage (66 %), last resort (66 %), directly communicated threat (0 %). Conclusions: The prevention of such cases seems to be most promising installing a regional and interdisciplinary threat management model. The field of threat management offers a scientific frame with evidence based tools and methods.