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Psychopaths are not crazy. They're fully aware of what they do and of the consequences of their actions.
~ Hannibal Lecter to Will Graham

Psychopaths are associate with psychopathic personality disorder, which is a mental illness. Sufferers of the psychopathic personality disorder show traits and symptoms of antisocial personality disorder, narcissistic personality disorder and/or paranoid personality disorder. Therefore, they have a lack of empathy and guilt, and an absence of deep emotional connections; as practical results, they tend to be extremely violent and twisted. This also means that they cannot be remorseful, exceptions aside.

Psychopathy is usually a persistent condition from birth, but it can be induced by a succession of horrific event that twisted the sanity of said characters. Such individuals are difficult to deal with in justice, because they might be not fully responsable of what they do (as they're ill), though as Lecter stated above, many of them enjoy harming other.

Please note that not all psychopaths are malicious. Some known as "Heroic sociopaths" are on the good side, although for completely practical reasons, not moral ones.

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