A comparison of the family and childhood backgrounds of hospitalised offenders with schizophrenia or personality disorder

Childhood adversity and conduct disorder: A developmental pathway to violence in schizophrenia

BACKGROUND

Both childhood adversity and conduct disorder are over-represented among adult patients with schizophrenia and have been proposed as significant factors that may increase the risk of violence. It is not known how childhood adversity and conduct disorder might interact to contribute towards an increased risk of violence in schizophrenia. This study aimed to explore the relationships between childhood adversity, conduct disorder and violence among men with schizophrenia.

METHODS

54 male patients with schizophrenia from a range of inpatient and outpatient mental health services were assessed for exposure to a variety of childhood adversities, conduct disorder before the age of 15 and later violent behaviour in adulthood.

RESULTS

Exposure to domestic violence during childhood was associated with an increased propensity to violence in adulthood. Symptoms of conduct disorder were associated both with cumulative exposure to childhood adversities and with later propensity to violence. The cumulative number of childhood adversities was associated with adult propensity to violence. This association was significantly attenuated by inclusion of conduct disorder in the model.

CONCLUSIONS

This is the first study to demonstrate an association between childhood exposure to domestic violence and later violent behaviour in schizophrenia. Conduct disorder may mediate the association between cumulative childhood adversities and adult propensity to violence, indicating an indirect pathway. These results indicate a complex interplay between childhood adversity, conduct disorder and later violent behaviour in schizophrenia, and suggest that there may be shared aetiological risk factors on a common developmental pathway to violence.

Temporary separation from parents in early childhood and serious personality disorders in adult life

We have previously shown that the temporary separation of Finnish children from both parents during World War II predicted any serious mental, substance use, and personality disorders in adulthood. Here we examine if parental separation is a specific vulnerability factor for any- and dramatic personality disorders relative to other mental disorders. We extracted information on separations from the Finnish National Archives and psychiatric diagnoses from the national Hospital Discharge and Causes of Death-Registers. Of the 12,734 Helsinki Birth Cohort Study participants, 1,717 were separated, 1,487 had any mental, 194 any personality, and 77 dramatic personality disorders. In those who were separated, the risk of any serious personality disorders was significantly higher also among individuals with any serious mental disorders. The increased risks of any serious and dramatic personality disorders were particularly characteristic of individuals separated before the age of five, and that of dramatic personality disorder of separated men. Parental separation may thus be a specific vulnerability factor for serious personality disorders.