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Polat H, Uğur K, Aslanoğlu E, Yıldız S, Yagin FH. The effect of functional remission and cognitive insight on criminal behavior in patients with schizophrenia. Arch Psychiatr Nurs 2023; 45:176-183. [PMID: 37544696 DOI: 10.1016/j.apnu.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/11/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
OBJECTıVE: This study was planned to determine the relationship of functional remission with a criminal history and determine its effect on criminal behavior in patients with schizophrenia. METHODS This cross-sectional study was conducted with 132 patients with schizophrenia (66 with and 66 without a criminal history). Data were collected between November 2020 and April 2021 using a personal information form, the Functional Remission of General Schizophrenia (FROGS), the Taylor Crime Violence Rating Scale, the Beck Cognitive Insight Scale, and the Positive and Negative Syndrome Scale (PANSS) was used to collect data. RESULTS In terms of all scale variables, there were significant differences between the groups with and without a criminal history (p < 0.05). These differences were mostly clearly observed in the FROGS-social functionality (effect size: 16.79), PANSS-positive (effect size: 2.62) and FROGS-health and treatment (effect size: 2) subscales. CONCLUSIONS In this study, it was determined that as the symptoms of the illness increased in schizophrenia, the patients' functional remission and insight decreased, and their tendency to commit crimes increased. Psychiatric nurses can plan therapeutic interventions to increase the functionality and insight levels of patients with schizophrenia.
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Affiliation(s)
- Hatice Polat
- Faculty of Health Sciences, Malatya Turgut Özal University, 44000 Malatya/Turkey.
| | - Kerim Uğur
- Department of Psychiatri, Faculty of Medicine, Malatya Turgut Özal University, 44000 Malatya, Turkey
| | - Eren Aslanoğlu
- Department of Medical Services and Techniques, Kovancilar Vocational School, Firat University, Elazig, Turkey
| | - Sevler Yıldız
- Department of Psychiatri, Faculty of Medicine, Erzincan Binali Yıldırım University, 24002 Erzincan, Turkey
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, 44280 Malatya, Turkey
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Liu Y, Liu X, Wen H, Wang D, Yang X, Tang W, Li Y, Zhang T, Yang M. Risk behavior in patients with severe mental disorders: a prospective study of 121,830 patients managed in rural households of western China. BMC Psychiatry 2018; 18:134. [PMID: 29776345 PMCID: PMC5960100 DOI: 10.1186/s12888-018-1709-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 04/30/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The management of severe mental disorder (SMD) patients in communities is an important initiative of healthcare reform in China. Yet the effects in terms of risk behavior of patients are unclear, particularly in rural areas. This study aims to examine high risk behaviors, changing trends, and possible associated factors among SMD patients in the rural areas of western China. METHODS This analysis examined incidence rate (IR) of high risk behavior of 121,830 managed SMD patients in rural area of Sichuan province, based on data from the national system from 2006 to 2013. Register rate, high risk behavior IR, and time distribution and area distribution of high risk behavior were described. Two-level Poisson regression model was used to analyze associates of high risk behavior of patients, which include demographic characteristics at individual level, socio-economic condition and health system indicators at region level. RESULTS It was revealed that 6804 (5.58%) of managed patients were involved in 17,220 high risk behavior events, which gave an overall IR of 0.0998 (per person year) on the basis of 172,564 person years of follow-up. The IR varied widely across municipalities, in the range of 0.0305-0.3397. The IR of high risk behavior in the cohort had increased since 2006, and peaked by 2011, at 0.2392. At the individual level, males aged 25 to 44, who were unmarried and in poverty, illiterate or semiliterate, had a family history of mental disorders and antipsychotic treatments, longer duration illnesses, were associated with an increased IR risk. At the regional level, higher psychiatric practitioner visits and the lower annual net income of rural residents per capita, were associated with an increased IR risk. CONCLUSIONS This is the first large prospective study that revealed the current situation of the register rate, high risk behavior incidence rate in SMD patients in rural area of western China, and examined associates and the differences of high risk behavior of patients among municipalities. The findings may provide evidences that lead to guide prevention and control for risk behavior in SMD patients in rural areas of China, as well as to improve mental health services for this population. It could provide some reference for other developing countries too.
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Affiliation(s)
- Yuanyuan Liu
- 0000 0001 0807 1581grid.13291.38Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Xiang Liu
- 0000 0001 0807 1581grid.13291.38Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Hong Wen
- Sichuan Provincial Mental Health Centre, Mianyang, Sichuan People’s Republic of China
| | - Dan Wang
- Sichuan Provincial Mental Health Centre, Mianyang, Sichuan People’s Republic of China
| | - Xianmei Yang
- Sichuan Provincial Mental Health Centre, Mianyang, Sichuan People’s Republic of China
| | - Weiwei Tang
- 0000 0001 0807 1581grid.13291.38Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan People’s Republic of China ,0000 0001 0807 1581grid.13291.38West China Research Center for Rural Health Development, Sichuan University, No.17 Section 3, South Renmin Road, Chengdu, Sichuan 610041 People’s Republic of China
| | - Yaxi Li
- 0000 0001 0807 1581grid.13291.38Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan People’s Republic of China ,0000 0001 0807 1581grid.13291.38West China Research Center for Rural Health Development, Sichuan University, No.17 Section 3, South Renmin Road, Chengdu, Sichuan 610041 People’s Republic of China
| | - Tao Zhang
- 0000 0001 0807 1581grid.13291.38Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Min Yang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China. .,West China Research Center for Rural Health Development, Sichuan University, No.17 Section 3, South Renmin Road, Chengdu, Sichuan, 610041, People's Republic of China.
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Shaoling Z, Jun W, Graham M, Chen C, Simei Z, Qiguang L, Qun W, Jiansong Z, Xiaoping W. Attitudes of Chinese community members and psychiatrists towards forensic psychiatric assessments. Psychiatry Res 2017; 258:283-288. [PMID: 28867405 DOI: 10.1016/j.psychres.2017.08.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 06/01/2017] [Accepted: 08/23/2017] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the attitudes of Chinese community members and psychiatrists towards forensic psychiatric assessments. A questionnaire designed to record attitudes toward the current forensic psychiatric assessment procedures and the disposal of mentally ill offenders was developed and distributed via a mobile App. A total of 134 community members and 132 psychiatrists voluntarily completed the questionnaire. Most of responders agreed that the department of public-security has the right to apply for a forensic psychiatric assessment but should not be held solely by that department. Community members were less significantly confident in the validation of forensic psychiatric opinions than were the psychiatrists. A significantly higher proportion of community members than psychiatrists considered that offenders judged Not Criminally Responsible on Account of Mental Disorder (NCRMD) should be punished as would be sane people. In addition, only a minority of responders supported that NCRMD should not be held criminally responsible. Our results indicate that both groups have comments on the current distribution of right of startup of forensic psychiatric assessments. Compared to psychiatrists, community members have lower confidence in the validation of forensic psychiatric assessment and have stricter attitudes toward the disposal of offenders with psychiatric disorders.
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Affiliation(s)
- Zhong Shaoling
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Wang Jun
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Mellsop Graham
- Waikato Clinical Campus, University of Auckland, New Zealand
| | - Chen Chen
- Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, PRC, Shanghai 200063, China
| | - Zhang Simei
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Li Qiguang
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Wang Qun
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Zhou Jiansong
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Wang Xiaoping
- Mental Health Institute of the Second Xiangya Hospital, Central South University, National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
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Li C, Wang XP, Zhang DK, Zhou JS, Guo M. An EEG study that may improve the violence risk assessment in male schizophrenic patients. AUST J FORENSIC SCI 2014. [DOI: 10.1080/00450618.2014.901415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Richard-Devantoy S, Bouyer-Richard AI, Jollant F, Mondoloni A, Voyer M, Senon JL. [Homicide, schizophrenia and substance abuse: a complex interaction]. Rev Epidemiol Sante Publique 2013; 61:339-50. [PMID: 23816066 DOI: 10.1016/j.respe.2013.01.096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 01/15/2013] [Accepted: 01/29/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND AIM The prevalence of homicide perpetrators with a diagnosis of schizophrenia is 6% in Western countries populations. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link. The aim of this systematic review was to clarify the role of substance abuse in the commission of murder in people suffering from schizophrenia. METHODS A systematic English-French Medline and EMBASE literature search of cohort studies, case-control studies and transversal studies published between January 2001 and December 2011 was performed, combining the MeSH terms "schizophrenia", "psychotic disorders", "homicide", "violence", "substance use disorder", and the TIAB term "alcohol". Abstract selection was based on the STROBE and PRISMA checklist for observational studies and systematic and meta-analysis studies, respectively. RESULTS Of the 471 selected studies, eight prospective studies and six systematic reviews and meta-analysis studies met the selection criteria and were included in the final analysis. Homicide committed by a schizophrenic person is associated with socio-demographic (young age, male gender, low socioeconomic status), historical (history of violence against others), contextual (a stressful event in the year prior to the homicide), and clinical risk factors (severe psychotic symptoms, long duration of untreated psychosis, poor adherence to medication). In comparison to the general population, the risk of homicide is increased 8-fold in schizophrenics with a substance abuse disorder (mainly alcohol abuse) and 2-fold in schizophrenics without any comorbidities. A co-diagnosis of substance abuse allows us to divide the violent schizophrenics into "early-starters" and "late-starters" according to the age of onset of their antisocial and violent behavior. The violence of the "early-starters" is unplanned, usually affects an acquaintance and is not necessarily associated with the schizophrenic symptoms. Substance abuse is frequent and plays an important role in the homicide commission. In addition, the risk of reoffending is high. In the "late-starters", the violence is linked to the psychotic symptoms and is directed to a member of the family. The reoffence risk is low and it depends on the pursuit of care or not. CONCLUSION Defining subgroups of violent schizophrenic patients would avoid stigmatization and would help to prevent the risk of homicide by offering a multidisciplinary care which would take into account any substance abuse.
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Affiliation(s)
- S Richard-Devantoy
- McGill University, Department of Psychiatry & Douglas Mental Health University Institute, McGill Group for Suicide Studies, FBC building, 3rd floor, 6875, boulevard Lassalle, Montréal (Qc), H3W 2N1, Canada.
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Fazel S, Singh JP, Doll H, Grann M. Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis. BMJ 2012; 345:e4692. [PMID: 22833604 PMCID: PMC3404183 DOI: 10.1136/bmj.e4692] [Citation(s) in RCA: 165] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2012] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the predictive validity of tools commonly used to assess the risk of violence, sexual, and criminal behaviour. DESIGN Systematic review and tabular meta-analysis of replication studies following PRISMA guidelines. DATA SOURCES PsycINFO, Embase, Medline, and United States Criminal Justice Reference Service Abstracts. REVIEW METHODS We included replication studies from 1 January 1995 to 1 January 2011 if they provided contingency data for the offending outcome that the tools were designed to predict. We calculated the diagnostic odds ratio, sensitivity, specificity, area under the curve, positive predictive value, negative predictive value, the number needed to detain to prevent one offence, as well as a novel performance indicator-the number safely discharged. We investigated potential sources of heterogeneity using metaregression and subgroup analyses. RESULTS Risk assessments were conducted on 73 samples comprising 24,847 participants from 13 countries, of whom 5879 (23.7%) offended over an average of 49.6 months. When used to predict violent offending, risk assessment tools produced low to moderate positive predictive values (median 41%, interquartile range 27-60%) and higher negative predictive values (91%, 81-95%), and a corresponding median number needed to detain of 2 (2-4) and number safely discharged of 10 (4-18). Instruments designed to predict violent offending performed better than those aimed at predicting sexual or general crime. CONCLUSIONS Although risk assessment tools are widely used in clinical and criminal justice settings, their predictive accuracy varies depending on how they are used. They seem to identify low risk individuals with high levels of accuracy, but their use as sole determinants of detention, sentencing, and release is not supported by the current evidence. Further research is needed to examine their contribution to treatment and management.
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Affiliation(s)
- Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
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Abstract
OBJECTIVE To undertake a systematic review and meta-analysis on the risk of repeat offending in individuals with psychosis and to assess the effect of potential moderating characteristics on risk estimates. METHODS A systematic search was conducted in 6 bibliographic databases from January 1966 to January 2009, supplemented with correspondence with authors. Studies that reported risks of repeat offending in individuals with psychotic disorders (n = 3511) compared with individuals with other psychiatric disorders (n = 5446) and healthy individuals (n = 71 552) were included. Risks of repeat offending were calculated using fixed- and random-effects models to calculate pooled odds ratios (ORs). Subgroup and meta-regression analyses were conducted to examine how risk estimates were affected by various study characteristics including mean sample age, study location, sample size, study period, outcome measure, duration of follow-up, and diagnostic criteria. RESULTS Twenty-seven studies, which included 3511 individuals with psychosis, were identified. Compared with individuals without any psychiatric disorders, there was a significantly increased risk of repeat offending in individuals with psychosis (pooled OR = 1.6, 95% confidence interval [CI] = 1.4-1.8), although this was only based on 4 studies. In contrast, there was no association when individuals with other psychiatric disorders were used as the comparison group (pooled OR = 1.0, 95% CI = 0.7-1.3), although there was substantial heterogeneity. Higher risk estimates were found in female-only samples with psychosis and in studies conducted in the United States. CONCLUSIONS The association between psychosis and repeat offending differed depending on the comparison group. Despite this, we found no support for the findings of previous reviews that psychosis is associated with a lower risk of repeat offending.
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Affiliation(s)
- Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
| | - Rongqin Yu
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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