The article examines symptomatology, neuropsychological functioning, and the nature of perpetrator-victim relationships of patients with psychotic disorders who were committed to a forensic psychiatric hospital following violent, primarily criminal, behavior. A severely violent group, composed primarily of psychotic patients charged with murder, is compared with a less severely violent group composed primarily of psychotic patients involved with property crimes. As compared with the less violent group, the severely violent group is more likely to have delusional beliefs about specific personal targets and to have delusions about significant others being replaced by impostors. These beliefs are accompanied by higher scores on neuropsychological tests of intellectual and academic abilities. A high number of their blood relatives were victims of psychotic murder. These results indicate that a higher incidence of lethal or near lethal acts of violence may characterize intellectually intact but psychotic individuals with organized delusions involving personal, accessible targets. Tables, references