The subjects were divided into three groups depending on the intensity of physical aggression used: sexual killing, rape attacks, or sexual attacks on children. The findings showed that over two-thirds (23) of the patients had at least one diagnosis of personality disorder according to DSM-III-R. This distribution of personality disorders differed little from comparable distributions in a general outpatient sample. Only seven subjects had elevated scores measuring antisocial personality disorder, but the rate of sadistic personality disorders was high (9 out of 30). For these patients, therapeutic strategies should focus on impulse control and reality testing. Cognitive therapy and psychotherapy need to be tailored to meet the needs of patients exhibiting other specific personality disorders. 4 tables and 8 notes