1
|
Ssekitto JM, Abaatyo J, Namatovu A, Akatusasira R, Kibet E, Kamau SG, Kaggwa MM. Filicide in Africa: a systematic review. BMC Public Health 2024; 24:2125. [PMID: 39107769 PMCID: PMC11302348 DOI: 10.1186/s12889-024-19625-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Filicide, the act of a parent or parental figure killing their child, has been reported in various African countries. However, there is a lack of comprehensive reviews on the prevalence and associated factors of filicide across the African continent, which is characterized by diverse cultural beliefs and practices. This review aims to examine the prevalence and risk factors of filicide in Africa. METHODS This review included studies on filicide in Africa, identified through searches in various databases (PubMed, Scopus, Africa Journal Online, and Google Scholar) using relevant keywords. The Mendeley reference manager was used to organize all identified articles and remove duplicate entries. A two-round screening process was conducted by two independent reviewers, with the final set of articles selected through mutual agreement. The quality of the studies was then assessed. RESULTS Out of the 107 retrieved articles, only 15 were included in the review. These studies revealed diverse prevalence rates: 3.7% of total homicides, 1.38% of deaths from family violence, and 13.02% for autopsied children. Various potential risk factors for filicide were identified, including unwanted pregnancies, marital conflicts, family disputes and violence, low socio-economic status, mental health issues in perpetrators, and mental, physical, or neurological vulnerabilities in victims. Cultural beliefs were also recognized as contributing factors to filicide. CONCLUSION Filicide is a complex and multi-dimensional issue influenced by various individual, familial, and societal factors. The review highlighted a high prevalence of filicide in Africa, shaped by these diverse factors.
Collapse
Affiliation(s)
| | - Joan Abaatyo
- Department of Psychiatry, Uganda Christian University, Kampala, Uganda.
- King Ceasor University, Kampala, Uganda.
| | - Angella Namatovu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Rita Akatusasira
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emmanuel Kibet
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| |
Collapse
|
2
|
Findeis H, Strauß M, Kröber HL. The TCO concept in German forensic homicide offenders with schizophrenia spectrum disorders - new findings from a file-based, retrospective cross-sectional study. Front Psychiatry 2024; 15:1404263. [PMID: 38919633 PMCID: PMC11196989 DOI: 10.3389/fpsyt.2024.1404263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction There is evidence that there is a small group of people with schizophrenia spectrum disorders who are more likely to commit homicide than those in the general population. However, there is limited knowledge about the psychopathology that leads to homicide in this group. The aim of this study was to examine two commonly used definitions of the Threat/Control-Override (TCO) concept, which aims to identify a certain risk of serious violence in patients with schizophrenia spectrum disorders. Methods This is a sub analysis of a file-based, retrospective and exploratory cross-sectional study. All forensic homicide offenders with schizophrenia spectrum disorders who were detained at the Forensic Hospital Berlin as of 31 December 2014 were examined for the occurrence of TCO according to two commonly used definitions. Results Of a total of 419 forensic patients with schizophrenia spectrum disorders, 78 committed homicide (18.6%). The forensic homicide offenders with schizophrenia spectrum disorders were characterised by being male, unemployed, single and having committed (attempted) manslaughter. Irrespective of the definition used, the entire TCO complex was present in less than a third of the sample. In both definitions, Threat symptoms were slightly less frequent than Control-Override symptoms. While Threat symptoms occurred less frequently in Stompe et al.'s definition, Control-Override symptoms were the most common. With regard to Kröber's definition of Threat and Control-Override, the situation is exactly the opposite. Discussion Regarding the entire TCO complex, Kröber's definition seems a little more open and Stompe et al.'s more strict (38.5% vs. 35.9%). Since TCO only occurs in about one third of the subjects in both definitions, neither definition appears to be conclusive. A combination with proportions from both definitions could be a contribution to a future definition of TCO. The present study provides scarcely published primary data on psychopathology in homicide offenders with schizophrenia spectrum disorders, especially on the much discussed TCO concept in two definitions. In order to determine the most useful definition of TCO, to avoid false positives and to identify clear psychopathological risk symptoms, larger samples and comparative studies with offenders and non-offenders should be conducted in the future.
Collapse
Affiliation(s)
- Hannelore Findeis
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
- Institut für Forensische Psychiatrie, Charité Berlin, Berlin, Germany
| | - Maria Strauß
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | | |
Collapse
|
3
|
Zhang L, Qi X, Wen L, Hu X, Mao H, Pan X, Zhang X, Fang X. Identifying risk factors to predict violent behaviour in community patients with severe mental disorders: A retrospective study of 5277 patients in China. Asian J Psychiatr 2023; 83:103507. [PMID: 36796125 DOI: 10.1016/j.ajp.2023.103507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Patients with Severe Mental Disorders (SMD) have a higher risk of violent behaviour than the general population. The study aimed to investigate the predictive factors for the occurrence of violent behaviour in community SMD patients. METHODS The cases and follow-up data were collected from SMD patient Information Management system in Jiangning District, Jiangsu Province. The incidence of violent behaviours was described and analyzed. Logistic regression model was used to examine the influencing factors for violent behaviours in those patients. RESULTS Among 5277 community patients with SMD in Jiangning District, 42.4% (2236/5277) had violent behaviours. The stepwise logistic regression analysis revealed that the disease-related factors (including disease type, disease course, times of hospitalization, medication adherence, past violent behaviours), the demographic factors (age, male sex, educational level, economic and social living status), and the policy-related factors (like free treatment, annual physical check, disability certificate, family physician services, and community interviews) were significantly related to the violent behaviours in community SMD patients. After gender stratification, we found that male patients with unmarried status and with a longer course of disease were more likely to violent. However, we found that female patients with lower economic status and educational experience were more likely to violent. CONCLUSION Our results suggest that community SMD patients had a high incidence of violent behaviour. The findings may provide valuable information for policymakers and mental health professionals worldwide taking a number of measures to reduce the incidence of violence in community SMD patients and to better maintain social security.
Collapse
Affiliation(s)
- Lin Zhang
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xin Qi
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Lu Wen
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xiuxiu Hu
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Hongjun Mao
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xinming Pan
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
| | - Xinyu Fang
- Department of Geriatric Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| |
Collapse
|
4
|
Mok PLH, Walter F, Carr MJ, Antonsen S, Kapur N, Steeg S, Shaw J, Pedersen CB, Webb RT. Absolute risks of self-harm and interpersonal violence by diagnostic category following first discharge from inpatient psychiatric care. Eur Psychiatry 2023; 66:e13. [PMID: 36649931 PMCID: PMC9970150 DOI: 10.1192/j.eurpsy.2022.2352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Persons discharged from inpatient psychiatric services are at greatly elevated risk of harming themselves or inflicting violence on others, but no studies have reported gender-specific absolute risks for these two outcomes across the spectrum of psychiatric diagnoses. We aimed to estimate absolute risks for self-harm and interpersonal violence post-discharge according to gender and diagnostic category. METHODS Danish national registry data were utilized to investigate 62,922 discharged inpatients, born 1967-2000. An age and gender matched cohort study was conducted to examine risks for self-harm and interpersonal violence at 1 year and at 10 years post-discharge. Absolute risks were estimated as cumulative incidence percentage values. RESULTS Patients diagnosed with substance misuse disorders were at especially elevated risk, with the absolute risks for either self-harm or interpersonal violence being 15.6% (95% CI 14.9, 16.3%) of males and 16.8% (15.6, 18.1%) of females at 1 year post-discharge, rising to 45.7% (44.5, 46.8%) and 39.0% (37.1, 40.8%), respectively, within 10 years. Diagnoses of personality disorders and early onset behavioral and emotional disorders were also associated with particularly high absolute risks, whilst risks linked with schizophrenia and related disorders, mood disorders, and anxiety/somatoform disorders, were considerably lower. CONCLUSIONS Patients diagnosed with substance misuse disorders, personality disorders and early onset behavioral and emotional disorders are at especially high risk for internally and externally directed violence. It is crucial, however, that these already marginalized individuals are not further stigmatized. Enhanced care at discharge and during the challenging transition back to life in the community is needed.
Collapse
Affiliation(s)
- P L H Mok
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy & Optometry, The University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
| | - F Walter
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, United Kingdom
| | - M J Carr
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy & Optometry, The University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom
| | - S Antonsen
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.,National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - N Kapur
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| | - S Steeg
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| | - J Shaw
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| | - C B Pedersen
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark.,National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - R T Webb
- Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.,National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, United Kingdom.,Centre for Mental Health and Safety, Division of Psychology & Mental Health, The University of Manchester, Manchester, United Kingdom
| |
Collapse
|
5
|
Tzeng NS, Wang HY, Chou YC, Kuo SC, Chen CY, Chen TY. Court-Ordered forensic psychiatric evaluations for offenders with schizophrenia with homicide charges in Taiwan. JOURNAL OF MEDICAL SCIENCES 2023. [DOI: 10.4103/jmedsci.jmedsci_98_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
|
6
|
Muacevic A, Adler JR, Alafghani LA, Alfaraj AF, Alkhalifah GS, Bin Jalalah NH, Alsuwailem NA, Hilal RM. Homicide in Relation to Mental Illness: Stigma Versus Reality. Cureus 2022; 14:e32924. [PMID: 36578842 PMCID: PMC9790173 DOI: 10.7759/cureus.32924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 12/26/2022] Open
Abstract
This narrative review examines different aspects of homicide among mentally ill individuals to compare the rates of homicide by offenders with and without mental illness and investigate the stigma of mental illness and its consequences. It also evaluates the motives of mentally ill perpetrators and their characteristics and explores weapons of choice in homicides related to different mental disorders. Studies confirmed higher homicide rates among specific categories of mentally ill individuals who experienced maltreatment, unemployment, abuse in childhood, and substance abuse resulting from stigma and discrimination. The motives were mainly revenge, argument, financial gain, sexuality, sadism, and filicide, with revenge being the top motive. Offenders were found to have close relationships with their victims in most cases. Sharp instruments were the most commonly used weapons. Our review confirms the lack of evidence linking mental illness independently with homicide, both globally and in Arab countries, and highlights the impact of discrimination toward mentally ill individuals. This discrimination and stigma lead to delayed care-seeking and self-destructive behavior, which is linked to higher homicide rates among persons with and without mental illness.
Collapse
|
7
|
Fekih-Romdhane F, Abboud C, Kossaify M, El Khoury N, Sleiman YB, Hachem D, Haddad G, Hallit S. Child abuse and aggressiveness in individuals diagnosed with schizophrenia in Lebanon. Perspect Psychiatr Care 2022; 58:2872-2880. [PMID: 35767392 DOI: 10.1111/ppc.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To identify individual and clinical risk factors of aggressiveness, including exposure to different forms of childhood trauma, in a sample of Lebanese patients with schizophrenia. METHODS A total of 131 patients diagnosed with schizophrenia participated in this cross-sectional study. RESULTS Higher physical (Beta = 0.24, p < 0.001) and sexual (Beta = 0.29, p = 0.003) abuse, alcohol drinking (Beta = 1.46, p = 0.008), having a history of head trauma (Beta = 1.10, p = 0.041), and male gender (Beta = -1.59, p = 0.009) were significantly associated with higher mean aggression scores. PRACTICAL IMPLICATIONS Our investigation of the factors linked to aggressiveness in patients with schizophrenia complement those of earlier findings, showing that the relationship between interacting individual and environmental risk factors and later aggressiveness is quite complex, and needs further longitudinal and prospective studies.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- Department of Psychiatry "Ibn Omrane", The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Manouba, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Cedric Abboud
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Mikhael Kossaify
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Nour El Khoury
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Yara Bou Sleiman
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Dory Hachem
- Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia
| |
Collapse
|
8
|
Sfendla A, Martinsson B, Filipovic Y, Senhaji M, Kerekes N. Psychological distress in a sample of Moroccan prisoners with drug-dependence. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1093-1108. [PMID: 33882747 PMCID: PMC9245157 DOI: 10.1177/0306624x211010286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Research regarding mental illness and drug addiction among inmates in Morocco requires increased knowledge; previous literature reported that prisoners suffer from severe psychological distress. The present study aimed to provide information about Moroccan prisoners' psychological distress and define the differences in psychological distress levels among inmates with and without drug-dependence. A sample of 177 male inmates completed a set of surveys, including the Drug Use Disorders Identification Test (DUDIT) and the Brief Symptom Inventory (BSI). The "Drug dependence" group scored significantly higher psychological distress levels in each of the BSI domains. The strongest differences were measured in the General Severity Index (GSI), hostility, and depression scales. Moroccan prison inmates have high psychological distress, and those with drug-dependence have even higher. There is a need of psychiatric assessment, selection, and care possibilities in prison inmate populations.
Collapse
Affiliation(s)
- Anis Sfendla
- Higher Institute of Nursing Professions and Health Techniques, Errachidia, Morocco
- Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Tetouan, Morocco
- Department of Biology, Faculty of Sciences and Techniques, Moulay Ismail University, Errachidia, Morocco
| | - Björn Martinsson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Ylva Filipovic
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Meftaha Senhaji
- Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Tetouan, Morocco
| | - Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
| |
Collapse
|
9
|
Guo Y, Yang X, Wang D, Fan R, Liang Y, Wang R, Xiang H, Liu Y, Liu X. Prevalence of violence to others among individuals with schizophrenia in China: A systematic review and meta-analysis. Front Psychiatry 2022; 13:939329. [PMID: 35935404 PMCID: PMC9354073 DOI: 10.3389/fpsyt.2022.939329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/04/2022] [Indexed: 01/28/2023] Open
Abstract
Background Violence to others (hereinafter referred to as "violence-TO") is common in individuals with schizophrenia. The reported prevalence of violence-TO among schizophrenics ranges widely in existing studies. Improved prevalence estimates and identification of moderators are needed to guide future management and research. Methods We searched EBSCO, EMBASE, Medline, PubMed, Science Direct, Web of Science, CNKI, VIP, WANFANG data, and CBM for relevant articles published before June 5, 2022. Meanwhile, violence-TO was summarized into four categories: (a) violence-TO on the reviews of official criminal or psychiatric records (type I); (b) less serious forms of violence-TO (type II); (c) physical acts causing demonstrable harm to victims (type III); (d) homicide (type IV). We did meta-analysis for the above types of violence-TO, respectively, and applied subgroup analyses and meta-regression analyses to investigate the source of heterogeneity. Results A total of 56 studies were eligible in this study and 34 of them were high-quality. The prevalence of type I to type IV in individuals with schizophrenia in China was 23.83% (95% CI: 18.38-29.75%), 23.16% (95% CI: 8.04-42.97%), 17.19% (95%CI: 8.52-28.04%), and 0.62% (95% CI: 0.08-1.54%) respectively. The results of the subgroup analysis showed that the prevalence of type I was higher among subjects in the inland than in the coastal non-economic zone, while the prevalence of type III was the highest in the coastal economic zone, followed by the inland region and the lowest in the coastal non-economic zone. The results of multivariate meta-regression analyses showed that: patient source in type I (β = 0.15, P < 0.01), patient source (β = 0.47, P < 0.01), and proportion of male (β = 0.19, P < 0.01) in type II, age (β = 0.25, P < 0.01), and GDP per capita (β = 0.05, P = 0.01) in type III were statistically significant. Conclusion The prevalence of different types of violence-TO and their influencing factors varied. Therefore, the authorities should take different management measures. In addition to individual factors, regional factors may also affect violence-TO, which suggests the need for a multi-sectorial approach to prevention and treatment for subjects in different regions and adopting targeted control strategies. Systematic Review Registration [www.ClinicalTrials.gov], identifier [CRD42021269767].
Collapse
Affiliation(s)
- Yi Guo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xianmei Yang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Dan Wang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Ruoxin Fan
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yiying Liang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rongke Wang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Hu Xiang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
10
|
He Y, Gu Y, Yu M, Li Y, Li G, Hu Z. Research on interpersonal violence in schizophrenia: based on different victim types. BMC Psychiatry 2022; 22:172. [PMID: 35260126 PMCID: PMC8903153 DOI: 10.1186/s12888-022-03820-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 02/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schizophrenia is one of the most common severe mental disorders associated with an increased risk of violence. The present study compares the demographical, clinical, and criminological characteristics of the patients with schizophrenia who committed different types of violence to relatives, acquaintances, or strangers. METHOD Archives of the violent offenders with schizophrenia referred to forensic psychiatric assessments from January 2015 to December 2019 in the West China Forensic Medicine Assessment Center in China were analyzed. The demographic information, mental illness history, and criminological characteristics of the offenders were collected. The clinical symptoms, previous violent behaviors, and social deficits were also evaluated. One-way ANOVA, Kruskal-Wallis test, Chi-square test, and logistic regression analysis were enrolled to do the statistical analysis. RESULTS The study enrolled 332 cases: 165 cases (49.7%) in the acquaintance victim group (AV), 96 cases (28.9%) in the relative victim group (RV), and 71 cases (21.4%) in the stranger victim group (SV). The multinomial logistic regression analysis revealed that older patients were less likely to attack relatives (OR = 0.966, 95% CI = 0.944-0.990; p = 0.005), and strangers, (OR = 0.971, 95% CI = 0.944-0.998; p = 0.034). Patients who lived with others were more inclined to attack relatives (OR = 15.057, 95% CI = 3.508-64.628; p < 0.001). Additionally, employed patients were more likely to attack strangers (OR = 2.034, 95% CI = 1.036-3.994; p = 0.039). The regression equation did not include psychiatric symptoms. For RV and AV victims, the risk of death was higher compared to that of SV victims (OR = 13.778, p < 0.001; OR = 2.663, p = 0.014). CONCLUSION In the interpersonal violence cases committed by schizophrenia patients, the victim type correlates with demographic characteristics of offenders such as living situation, age, and employment status, but not with the psychiatric symptoms. The majority of victims were acquaintances and relatives, and the relative victims having more severe injuries. In order to decrease interpersonal violence, especially violent crimes, more people, especially family members and neighbors, should be educated about symptoms of schizophrenia, the ways to communicate with the patients, and the methods for crisis management.
Collapse
Affiliation(s)
- Yong He
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Yan Gu
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Meiling Yu
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Yan Li
- grid.13291.380000 0001 0807 1581Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan 610041 Chengdu, China
| | - Gangqin Li
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, 610041, Chengdu, China.
| | - Zeqing Hu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, 610041, Chengdu, China.
| |
Collapse
|
11
|
Isailă OM, Hostiuc S, Teodor M, Curcă GC. Particularities of Offenders Imprisoned for Domestic Violence from Social and Psychiatric Medical-Legal Perspectives. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1187. [PMID: 34833406 PMCID: PMC8625331 DOI: 10.3390/medicina57111187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/29/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022]
Abstract
Background and Objectives: It is known that there may be an interconditionality between social status, personality disorders, and aggressive behavior. This study aimed to analyze the social and psychiatric diagnosis characteristics in subjects imprisoned for domestic violence acts compared to other types of aggressive behaviors. Materials and Methods: We performed a retrospective study using psychiatric medical-legal reports at the National Institute of Legal Medicine "Mina Minovici" Bucharest from 2016 to 2020. Results: We included 234 cases in our analysis, from which 132 (56%) were domestic violence offenders (DVO), and 102 (44%) were violence offenders imprisoned for other aggressions (OVO). Overall, DVOs were older than OVOs (43.0 +/- 14.7 vs. 36.1 +/- 16.6 years-old). In both study groups, most subjects were men, but the DVO group had more women than the OVO group: 23 cases (17%) and 3 cases (3%), respectively. In 14 cases (11%), previous criminal records were found from the DVO and 31 (30%) from the OVO group. Significantly fewer DVO were chronic psychoactive substance users: 83 (63%) in the DVO group versus 78 (86%) in the OVO group. Significantly more DVO had suicidal tendencies 26 (20%) compared to OVO 9 (9%). DVO subjects had significantly less often unsocialized conduct disorder or antisocial personality disorder compared to the OVO group. Conclusions: We found that DVO, compared to the OVO, were more numerous, older, less abusive, with a less frequent history of psychoactive substance abuse and addictions, and were less frequently indifferent to the committed acts.
Collapse
Affiliation(s)
- Oana-Maria Isailă
- Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, “Carol Davila University” of Medicine and Pharmacy, RO-020021 Bucharest, Romania;
- “Mina Minovici” National Institute of Legal Medicine, RO-042122 Bucharest, Romania; (M.T.); (G.-C.C.)
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, “Carol Davila University” of Medicine and Pharmacy, RO-020021 Bucharest, Romania;
- “Mina Minovici” National Institute of Legal Medicine, RO-042122 Bucharest, Romania; (M.T.); (G.-C.C.)
| | - Mihai Teodor
- “Mina Minovici” National Institute of Legal Medicine, RO-042122 Bucharest, Romania; (M.T.); (G.-C.C.)
| | - George-Cristian Curcă
- “Mina Minovici” National Institute of Legal Medicine, RO-042122 Bucharest, Romania; (M.T.); (G.-C.C.)
- Department of Legal Medicine and Bioethics, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, RO-020021 Bucharest, Romania
| |
Collapse
|
12
|
Gümüş T, Cesur E, Keyvan A, Türkcan A. Comparison of the sociodemographic, clinical and offense-related data of delusional disorder patients with and without a criminal history. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 29:631-643. [PMID: 35903497 PMCID: PMC9318258 DOI: 10.1080/13218719.2021.1956386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study investigates the relationship of delusional disorder and its subtypes to criminal and violent behavior by comparing the sociodemographic and clinical characteristics of patients with and without a criminal history and identifying predictors of crime. The records of 346 patients with a delusional disorder diagnosis were retrospectively evaluated using a sociodemographic data form, a crime violence rating scale and the Overt Aggression Scale (OAS). The results show that homicide and attempted homicide were committed more frequently by patients with jealous delusions, whereas verbal assault and crimes against the public were committed more frequently by patients with persecutory and other delusions. Patients with a criminal history had more hospital admissions and longer stays. Marital status, persecutory delusions, a high OAS score and older age were found to be associated with higher risk of crime. Clinical subtypes and sociodemographic characteristics seem to discriminate delusional disorder patients' risk of crime.
Collapse
Affiliation(s)
- Tuğba Gümüş
- Istanbul Training and Research Hospital, Psychiatry Unit, Istanbul, Turkey
| | - Ender Cesur
- Council of Forensic Medicine, Psychiatry Unit, Istanbul, Turkey
| | - Ali Keyvan
- Council of Forensic Medicine, Psychiatry Unit, Istanbul, Turkey
| | - Ahmet Türkcan
- Neurology and Neurosurgery, Bakirkoy Research & Training Hospital for Psychiatry, Forensic Psychiatry Unit, Istanbul, Turkey
| |
Collapse
|
13
|
Petroni G, Mandarelli G, Marasco M, Catanesi R, Tavone AM, Potenza S, Marsella LT, Marella GL. From overkill to beheading: A case report of a schizophrenic matricide. J Forensic Sci 2021; 67:404-407. [PMID: 34346506 DOI: 10.1111/1556-4029.14829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
Initial evidence exists on a subtype of matricide committed by subjects suffering from severe mental disorders. Matricide perpetrators often undergo a forensic psychiatric evaluation during the subsequent criminal trial because of supposed legal insanity. The few studies on matricide by mentally disordered perpetrators suggested a possible association between such extreme form of violence and schizophrenia spectrum disorders, especially in case of active delusions or hallucinations. METHODS we analyze a case of a young male with a recent diagnosis of psychotic disorder who committed matricide by inflicting multiple injuries and beheading. Data emerging from the forensic pathological analysis of the victim, as well as the forensic psychiatric analysis of the matricide perpetrator are discussed within an interdisciplinary perspective. RESULTS the autopsy revealed multiple stab wounds in the regions of the upper limbs, abdomen, chest, and neck, the latter determining beheading. The forensic psychiatric evaluation yielded a diagnosis of schizophrenia and clarified the causal role in the homicidal behavioral of active psychotic symptoms. CONCLUSION the specific type of delusional content, and perpetrator-victim relationship might contribute explaining a subtype of extremely violent homicide in recent onset schizophrenia.
Collapse
Affiliation(s)
- Giulia Petroni
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," via Montpellier 1, Roma, Italy
| | - Gabriele Mandarelli
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Maurizio Marasco
- Department of Human Neurosciences, University of Roma Sapienza, Roma, Italy
| | - Roberto Catanesi
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Alessandro Mauro Tavone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," via Montpellier 1, Roma, Italy
| | - Saverio Potenza
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," via Montpellier 1, Roma, Italy
| | - Luigi Tonino Marsella
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata," via Montpellier 1, Roma, Italy
| | - Gian Luca Marella
- Department of Surgical Sciences, University of Rome "Tor Vergata," via Montpellier 1, Roma, Italy
| |
Collapse
|
14
|
Hachtel H, Nixon M, Bennett D, Mullen P, Ogloff J. Motives, Offending Behavior, and Gender Differences in Murder Perpetrators With or Without Psychosis. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:3168-3190. [PMID: 29759034 DOI: 10.1177/0886260518774304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Little is known whether differences exist in motivation and reactive/instrumental offense behaviors between murder offenders with and without psychotic disorder. To contribute to better prevention strategies, the aim of this study was to investigate offense characteristics in murder offenders with a psychotic, nonpsychotic or no psychiatric diagnosis, and whether these factors differ according to sex. This data study examined the population of murder offenders between 1997 and 2005 (N = 435) in Victoria, Australia. Apparent motive for murder was allocated to one of six classifications. Assignations of reactive versus instrumental offense categories, co-offending, victim-offender relationship were determined by review of case material. Mental health service usage and prevalence of mental illnesses were identified through data with the statewide register of contacts with the public mental health system. Of the 435 offenders, 43 (9.9%) had been diagnosed with a psychotic illness. Gender differences between and within offenders with and without a psychotic disorder were analyzed. Murder offenders with a psychotic disorder were 3.19 (95% confidence interval [CI] = [1.27, 8.03]) times more likely to be motivated by revenge than nonpsychotic offenders and those with no diagnosis (odds ratio [OR] = 2.46, 95% CI = [1.10, 5.53]). The diagnostic groups did not differ on premeditation of their offenses or prior convictions. Perpetrators with psychotic illness were significantly more likely to kill family members and others known to them. It appears that for the psychotic disorder group, the perception of having been wronged in some way is a potential risk marker for planning and committing a serious offense. Care should be taken to improve adherence and access to care to avoid possible future serious violence especially in female patients with a high burden of mental illness like schizophrenia or severe mood disorders.
Collapse
Affiliation(s)
- Henning Hachtel
- Swinburne University of Technology, Clifton Hill, Victoria, Australia
- University of Basel, Basel, Switzerland
| | - Margaret Nixon
- Swinburne University of Technology, Clifton Hill, Victoria, Australia
| | | | - Paul Mullen
- Monash University, Clayton, Victoria, Australia
| | - James Ogloff
- Swinburne University of Technology, Clifton Hill, Victoria, Australia
| |
Collapse
|
15
|
Hirjak D, Meyer-Lindenberg A, Brandt GA, Dreßing H. [Differential diagnostic distinction between substance-induced and primary psychoses: : Recommendations for general psychiatric and forensic practice]. DER NERVENARZT 2021; 93:11-23. [PMID: 33656571 PMCID: PMC8763934 DOI: 10.1007/s00115-021-01083-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
Substanzinduzierte psychotische Störungen (SIPS) sind häufig und für ca. 25 % der ersten Einweisungen in eine psychiatrische Klinik verantwortlich. Aus klinischer Sicht ist aufgrund ähnlicher psychopathologischer Phänomene die diagnostische Unterscheidung zwischen SIPS und primären (genuinen oder kryptogenen) psychotischen Störungen oft eine Herausforderung. Dieser Umstand wird dadurch erschwert, dass SIPS im Zusammenhang mit Cannabis, Halluzinogenen und Amphetaminen ein erhebliches Risiko des Übergangs in eine primäre psychotische Störung (z. B. Schizophrenie) haben. Im ersten Abschnitt dieser Arbeit werden zunächst zwei exemplarische Fallvignetten aus der allgemeinpsychiatrischen und forensischen Praxis vorgestellt. Danach wird im Sinne einer selektiven Literaturübersicht die Relevanz der differenzialdiagnostischen Unterscheidung beider Störungsbilder aus der Sicht der allgemeinen und forensischen Psychiatrie in Bezug auf Therapie, Prognose und richterliche Entscheidung bezüglich der Unterbringung im Maßregelvollzug (§ 63 vs. § 64 StGB) beleuchtet. Der letzte Abschnitt hat das Ziel, ein strukturiertes Vorgehen zur differenzialdiagnostischen Unterscheidung zwischen SIPS und primären psychotischen Störungen zu erarbeiten. Die in dieser Arbeit dargestellten und diskutierten Konzepte und Befunde sollen klinisch tätigen Psychiatern und Psychologen die Diagnosestellung im allgemeinen und forensischen Kontext erleichtern.
Collapse
Affiliation(s)
- Dusan Hirjak
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland.
| | - Andreas Meyer-Lindenberg
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland
| | - Geva A Brandt
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland
| | - Harald Dreßing
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland
| |
Collapse
|
16
|
Dangerous or merely ‘difficult’? The new population of forensic mental hospitals. Eur Psychiatry 2020; 24:365-72. [DOI: 10.1016/j.eurpsy.2009.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2008] [Revised: 05/19/2009] [Accepted: 07/20/2009] [Indexed: 11/22/2022] Open
Abstract
AbstractBackgroundDuring recent decades, there has been a substantial increase in admissions to forensic mental hospitals in several European countries. It is not known if reforms implemented in mental health policies and practices are responsible for this development.ObjectiveOur study examined the development of mental health care in Austria and the incidence and prevalence of mentally disordered offenders judged not guilty by reason of insanity (NGRI).MethodsWe analysed data on service provision and data from criminal statistics between 1970 and 2008 from several national sources.ResultsDuring the first decade when reforms to mental health practice were implemented, the incidence and prevalence of offenders judged NGRI remained unchanged, despite a reduction of mental hospital beds by nearly 50% and little outpatient care. Surprisingly, the enormous increase in admissions to forensic inpatient treatment began in Austria only after community mental health services were rolled out across the country in the 1990s. This increase was primarily due to admissions of patients who had committed less severe offences, while rates of those who had committed homicide remained unchanged.ConclusionOur results cannot be explained by details of the reforms such as the downsizing of mental hospitals or a lack of outpatient facilities, nor by changes to criminal sentencing. Rather, the results provide evidence of an increasingly inadequate provision of comprehensive care for “difficult” but not extremely dangerous psychotic patients living in the community. This may result from the attitudes of mental health professionals who have become less inclined to integrate aggressive behaviour into their understanding of psychosis. As a consequence, increasing numbers of “difficult” patients end up in forensic psychiatric institutions. This development, which can be observed in nearly all European countries, raises concerns with regard to efforts to destigmatize both patients and psychiatry.
Collapse
|
17
|
Yeo DCK, Singham T, Poremski D. The presence of alcohol consumption prior to homicide in Singapore. Asian J Psychiatr 2019; 44:80-85. [PMID: 31326769 DOI: 10.1016/j.ajp.2019.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/25/2019] [Accepted: 07/07/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the prevalence of alcohol use disorders in people charged with homicide in Singapore. We also sought to determine which historical risk factors were associated with the use of alcohol 24 h prior to the homicide and with the presence of a severe mental illness at the material time of the offence. METHODS We extracted data from administrative records of all people charged with homicide in Singapore between 2007 and 2014. We used regression models to adjust for known confounding variables and explore the relationship between alcohol use and homicide. RESULTS Of 253 homicide offenders, 141 individuals (56%) meeting criteria for alcohol use disorders at the time of the offence. 121 offenders (48%) consumed alcohol within the 24 h preceding the homicide. Of the 149 that met criteria for a psychiatric diagnosis, 35 had a severe mental illness. CONCLUSION Alcohol use disorders are by far the most common disorder diagnosed in people charged with homicide in Singapore. Alcohol use is less common in homicide offenders with SMI.
Collapse
|
18
|
Walter F, Carr MJ, Mok PLH, Antonsen S, Pedersen CB, Appleby L, Fazel S, Shaw J, Webb RT. Multiple adverse outcomes following first discharge from inpatient psychiatric care: a national cohort study. Lancet Psychiatry 2019; 6:582-589. [PMID: 31171451 PMCID: PMC6586943 DOI: 10.1016/s2215-0366(19)30180-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/28/2019] [Accepted: 04/12/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Discharged psychiatric inpatients are at elevated risk of serious adverse outcomes, but no previous study has comprehensively examined an array of multiple risks in a single cohort. METHODS We used data from the Danish Civil Registration System to delineate a cohort of all individuals born in Denmark in 1967-2000, who were alive and residing in Denmark on their 15th birthday, and who had been discharged from their first inpatient psychiatric episode at age 15 years or older. Each individual in the discharged cohort was matched on age and sex with 25 comparators without a history of psychiatric admission. Data linked to each individual were also obtained from the Psychiatric Central Research Register, Register of Causes of Death, National Patient Register, and the National Crime Register. We used survival analysis techniques to estimate absolute and relative risks of all-cause mortality, suicide, accidental death, homicide victimisation, homicide perpetration, non-fatal self-harm, violent criminality, and hospitalisation following violence, until Dec 31, 2015. FINDINGS We included 62 922 individuals in the discharged cohort, and 1 573 050 matched comparators. Risks for each of all eight outcomes examined were markedly elevated in the discharged cohort relative to the comparators. Within 10 years of first discharge, the cumulative incidence of death, self-harm, committing a violent crime, or hospitalisation due to interpersonal violence was 32·0% (95% CI 31·6-32·5) in the discharged cohort (37·1% [36·5-37·8] in men and 27·2% [26·7-27·8] in women). Absolute risk of at least one adverse outcome occurring within this timeframe were highest in people diagnosed with a psychoactive substance use disorder at first discharge (cumulative incidence 49·4% [48·4-50·4]), and lowest in those diagnosed with a mood disorder (24·4% [23·6-25·2]). For suicide and non-fatal self-harm, risks were especially high during the first 3 months post-discharge, whereas risks for accidental death, violent criminality, and hospitalisation due to violence were more constant throughout the 10-year follow-up. INTERPRETATION People discharged from inpatient psychiatric care are at higher risk than the rest of the population for a range of serious fatal and non-fatal adverse outcomes. Improved inter-agency liaison, intensive follow-up immediately after discharge, and longer-term social support are indicated. FUNDING Medical Research Council, European Research Council, and Wellcome Trust.
Collapse
Affiliation(s)
- Florian Walter
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Matthew J Carr
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Pearl L H Mok
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Sussie Antonsen
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Carsten B Pedersen
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Louis Appleby
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Seena Fazel
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Warneford Hospital, Oxford, UK
| | - Jenny Shaw
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK
| | - Roger T Webb
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK; National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester, UK.
| |
Collapse
|
19
|
Kageyama M, Solomon P. Physical violence experienced and witnessed by siblings of persons with schizophrenia in Japan. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2018.1563462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Masako Kageyama
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Phyllis Solomon
- Department of Health Promotion Science, Osaka University Graduate School of Medicine, Osaka, Japan
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
20
|
Wang J, Zhang SM, Zhong SL, Mellsop G, Guo HJ, Li QG, Zhou JS, Wang XP. Gender differences among homicide offenders with schizophrenia in Hunan Province, China. Psychiatry Res 2019; 271:124-130. [PMID: 30472507 DOI: 10.1016/j.psychres.2018.11.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 11/26/2022]
Abstract
This study aimed to understand the demographic, clinical and criminological characteristics of Chinese homicide offenders with schizophrenia from a gender-based perspective. Information on all homicide offenders with schizophrenia who received forensic psychiatric assessment between 2010 and 2016 in Hunan Province, China, was systematically retrieved (n = 669). Gender differences in the above characteristics were analyzed, and independent correlates of homicide were explored. The male to female ratio of homicide offenders was about 4:1. Proportionally more males were single, unemployed and younger when committing their first crime than was apparent in females. Male perpetrators were more often influenced by delusions. Females were more likely to target their close family members. For males, living in rural areas and having a family history of mental disorder were positively associated with homicide, while having a criminal history and being unemployed were negatively associated. For females, younger age was positively, while being unmarried and unemployment were negatively associated with homicide. Our results indicate significant gender differences among Chinese homicide offenders with schizophrenia in demographic, clinical and criminological characteristics and in independent correlates of homicide. Further research in this field, especially aims at determining risk factors for crime in this population, should take the gender differences into account.
Collapse
Affiliation(s)
- Jun Wang
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China; Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, Jiangsu 214151, China
| | - Si-Mei Zhang
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China; Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen 518003, China
| | - Shao-Ling Zhong
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Graham Mellsop
- Waikato Clinical Campus, University of Auckland, New Zealand
| | - Hui-Juan Guo
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Qi-Guang Li
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Jian-Song Zhou
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China
| | - Xiao-Ping Wang
- 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, 139 Middle Renmin Road, Changsha, Hunan 410011, China.
| |
Collapse
|
21
|
Kachouchi A, Sebbani M, Salim S, Adali I, Manoudi F, Amine M, Asri F. Facteurs de risque de passage à l’acte d’homicide chez des patients marocains atteints de schizophrénie. Encephale 2018; 44:409-414. [DOI: 10.1016/j.encep.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/03/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022]
|
22
|
Bouthier M, Mahé V. [Paranoid personality disorder and criminal offense]. Encephale 2018; 45:162-168. [PMID: 30309614 DOI: 10.1016/j.encep.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/13/2018] [Accepted: 07/23/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Currently, all of the studies that focus on the relationship between paranoia and criminal offenses exclusively concern subjects suffering from a delusional paranoid disorder. However, subjects with single paranoid personality disorder, without any associated delusional disorder, are not uncommon in forensic practice. OBJECTIVES This study aims to describe the offenses committed by subjects suffering from a single paranoid personality disorder and to compare them with the offenses committed by the subjects affected by a paranoid delusional disorder associated with paranoid personality disorder. Our initial hypothesis is that both populations have a comparable criminological profile. METHODS Based on a 17 year-long experience carried out in the framework of a forensic assessment, we have selected all subjects presenting a paranoid personality disorder, whether single or associated with paranoid delusional disorder. The selected individuals were divided into two groups according to whether they presented paranoid delusional disorder or not. The offenses were grouped into criminal categories. The alpha risk was fixed at 1%. Data analysis is done by SAS software version 9.4. RESULTS In a sample of 106 subjects presenting a paranoid personality disorder, including 4 women and 102 men, we found 79 subjects with a single paranoid personality and 27 with an associated paranoid delusional disorder. The average age at the time of the offense was 41 for those with single personality disorders and 49 for those with paranoid delusional disorders. Both groups had forensic antecedents (41%, 11/27 of paranoid delusional disorder and 51%, 40/79 of single paranoid personality disorder). Psychiatric history was more frequent in the paranoid delusional disorder group (59%, 16/27) than in the single paranoid personality disorder group (13%, 10/79). History of addiction was comparable in terms of alcohol abuse (26% in both groups) and other substances (7.5%, 2/27 of paranoid delusional disorder and 9%, 7/79 of single paranoid personality disorder). Comparison of the two groups highlighted significant differences in the type of criminal offenses committed (Fisher's exact test: P=0.0003, alpha risk <0.0001). The offenses committed by delusional authors essentially came down to verbal or physical violence, including homicide (44%, 12/27), and were usually focused on a designated persecutor. Sexual violence was rare. On the other hand, paranoid personality disorder was associated with a wider variety of offenses. Sexual offenses (including 28 rapes, 35%, 28/79) were thus almost as frequent as murder, and attempted murder (38%, 30/79). This diversity of committed offenses was found in their forensic antecedents. In these subjects, the logic of omnipotence may had over ruled the logic of revenge. CONCLUSION We conducted a retrospective study on 106 subjects with paranoid personality disorder, including 27 subjects with associated paranoid delusional disorder. The comparison of the two groups demonstrated significant differences in offenses. Verbal and physical but non-sexual violence, committed in a delusional logic, was found among delusional subjects, while the forms of violence were more multiform in the single paranoid personality disorder group, frequently including sexual violence. This is, as far as we know, the first study describing the medico-legal acting-out of paranoid personalities. These results, which will need to be confirmed by future studies, point out the importance of the criminological risk that may be associated with paranoid personality disorder, without any associated delusional disorder.
Collapse
Affiliation(s)
- M Bouthier
- CHG de Meaux, grand hôpital de l'Est Francilien, site de Meaux, pôle de psychiatrie et addictologie, 6-8, rue Saint-Fiacre, 77100 Meaux, France
| | - V Mahé
- CHG de Meaux, grand hôpital de l'Est Francilien, site de Meaux, pôle de psychiatrie et addictologie, 6-8, rue Saint-Fiacre, 77100 Meaux, France.
| |
Collapse
|
23
|
Bouchard JP, Brulin-Solignac D, De Jésus A, Floris E, Quillerou B, Lodetti C, Soulan X. Délires paranoïaques, dangerosités et homicides. ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2018.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
Ntounas P, Katsouli A, Efstathiou V, Pappas D, Chatzimanolis P, Touloumis C, Papageorgiou C, Douzenis A. Comparative study of aggression - Dangerousness on patients with paranoid schizophrenia: Focus on demographic data, PANSS, drug use and aggressiveness. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 60:1-11. [PMID: 30217324 DOI: 10.1016/j.ijlp.2018.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/12/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
Abstract
This cross sectional study aimed to compare the differences in psychopathology of Greek homicide and homicide attempters, patients with schizophrenia, with non violent individuals, suffering from schizophrenia. The study compared three Groups of 220 men, diagnosed with schizophrenia: (a) Group Α (Schizophrenia - No violence, (b) Group Β (Schizophrenia - with violence or violent crime), (c) Group C (Schizophrenia - not guilty by reason of insanity - violent crime). Several psychometric tools were used, such as M.I.N·I (Mini-International Neuropsychiatric Interview), PANSS scale (Positive and Negative Symptoms Scale). Most subjects suffered from paranoid schizophrenia. On factors such as demographic characteristics (i.e. current occupational status, living status), statistically significant findings were shown for Groups B and C vs Group A. Predisposing psychosocial factors, such as family conflicts and aggressiveness against family, were found to be statistically significant in differentiating violent versus nonviolent individuals with psychosis. They differed significantly in factors like history of juvenile delinquency, but also in the type of aggressiveness in general. These differences were confirmed on PANSS scale. In conclusion, the longer the history of aggressiveness is presented, the greater the chances are of individuals falling into Group C and it is possible to spend several years from the onset of the disease until the moment of crime.
Collapse
Affiliation(s)
- Petros Ntounas
- Organization Against Drugs (OKANA), Athens, Greece; 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Attikon" General Hospital, Athens, Greece.
| | | | - Vasiliki Efstathiou
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Attikon" General Hospital, Athens, Greece
| | - Dimitris Pappas
- 5th Psychiatric Department, Psychiatric Hospital of Attica, "Dafni", Athens, Greece
| | | | | | - Charalampos Papageorgiou
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Eginition" Hospital, Athens, Greece
| | - Athanassios Douzenis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens Medical School, "Attikon" General Hospital, Athens, Greece
| |
Collapse
|
25
|
Abstract
The European Union now includes 27 member states. The Council of Europe stretches even further with 45 member states. A comprehensive definition of Europe geographically embraces all of Eastern Europe, including the western part of Russia and the western part of Turkey. Increasing mobility and national cooperation within Europe requires enhancing mutual knowledge and understanding of the context of evaluation and treatment of mentally disordered offenders and similar individuals who manifest antisocial behaviour and violence. A recent study confined to the previous 15 member states of the European Union provides a useful baseline for subsequent European comparisons (Salize & Dressing, 2005).
Collapse
|
26
|
Abstract
People with schizophrenia make a significant contribution to violence in our communities and, in so doing, often lay waste to their own lives. The 10% or so from which will emerge the perpetrators of most of the serious violence are identifiable in advance. A structured programme in which the criminogenic personality and behavioural factors, substance misuse and social dislocation are managed together with the active symptoms of the disorder could prevent the progress to violence. Such systems of care could significantly reduce serious criminal violence and homicide, reduce the number of people with schizophrenia who end up in prison, stop the rising number of forensic psychiatric beds and, most importantly, improve the lives of many of the most disturbed and disadvantaged of those with the disorder.
Collapse
|
27
|
Stompe T, Ritter K, Schanda H. Patterns of Substance Abuse in Offenders With Schizophrenia- Illness-Related or Criminal Life-Style? Front Psychiatry 2018; 9:233. [PMID: 29946271 PMCID: PMC6005895 DOI: 10.3389/fpsyt.2018.00233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/15/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The impact of substance abuse on violent behavior in patients suffering from schizophrenia is well-known. However, the association between the pattern of substance abuse and certain aspects of criminal behavior like the severity of offense, the previous history of violence and the age at onset of the criminal career is still unclear. Method: To assess the relationship between substance abuse, schizophrenia and violent behavior we examined healthy non-offenders; healthy offenders; non-offenders suffering from schizophrenia; and offenders suffering from schizophrenia, with respect to different patterns of substance abuse (none, alcohol only, illicit drugs only, and multiple substances). Results: Healthy offenders as well as offenders and non-offenders suffering from schizophrenia are characterized by increased rates of alcohol and illicit drug abuse. Especially multiple substance abuse appears to lower the threshold of aggression and illegal behavior. This effect is more pronounced in subjects suffering from schizophrenia. In both offender groups the abuse of psychoactive substances is associated with an earlier onset of the criminal career, but has no impact on the severity of the offenses. Conclusion: Our results point to the need for a differentiated view on the contribution of substance abuse to the criminality of subjects suffering from schizophrenia.
Collapse
Affiliation(s)
- Thomas Stompe
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.,Justizanstalt Göllersdorf, Göllersdorf, Austria
| | | | - Hans Schanda
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
28
|
Minero VA, Barker E, Bedford R. Method of homicide and severe mental illness: A systematic review. AGGRESSION AND VIOLENT BEHAVIOR 2017; 37:52-62. [PMID: 31354381 PMCID: PMC6660311 DOI: 10.1016/j.avb.2017.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
There is limited research that has examined offense characteristics in homicides committed by individuals with mental illness and with differing psychiatric diagnoses. The aim of this systematic review is to synthesize previous findings of studies analyzing homicide behavior by mentally ill individuals, and reporting any associations between mental illness and method of homicide. We searched four databases (MedLine, PsychINFO, Web of Science and Embase), and identified 52 relevant articles for analysis. Of these 52 articles, nine reported specific information on mental illness and method of homicide. Five out of nine articles revealed an association between schizophrenia/delusional disorder and the use of sharp instruments as a method of homicide. Four out of nine studies revealed an association between mood disorders (bipolar disorder/major depression) and strangulation/asphyxiation/suffocation/drowning. Our review confirms consistency across studies reporting a significant association between close contact methods and schizophrenia/mood disorders. Also identified as possible influential factors concerning weapon choice are illness duration, victim characteristics and planning/lack of planning of the homicide. Additionally, studies revealed up to 96% of severely mentally ill offenders experienced psychiatric symptoms at the time of the homicide. Future research may examine the presence of specific psychiatric symptoms when a mentally ill offender commits a homicide and whether these may be more influential in the method of homicide used than the psychiatric diagnosis of the offender.
Collapse
Affiliation(s)
- Valeria Abreu Minero
- Corresponding author: Valeria Abreu Minero, King’s College London, , Telephone No: +44 079 550 07228, Address: 16 De Crespigny Park, Camberwell, London, United Kngdom, SE5 8AF
| | - Edward Barker
- King’s College London, 16 De Crespigny Park, Camberwell, London, United Kngdom, SE5 8AF
| | - Rachael Bedford
- King’s College London, 16 De Crespigny Park, Camberwell, London, United Kngdom, SE5 8AF
| |
Collapse
|
29
|
Otte S, Vasic N, Nigel S, Streb J, Ross T, Spitzer C, Grabe HJ, Dudeck M. Different yet similar? Prisoners versus psychiatric patients - A comparison of their mental health. Eur Psychiatry 2017. [PMID: 28628826 DOI: 10.1016/j.eurpsy.2017.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous research indicates that prisoners have severe psychological distress. To assess their distress level and potential need for treatment, the present study compared the subjective psychological distress of long- and short-term prisoners with that of psychiatric and forensic patients. METHODS Long- (n=98) and short-term prisoners (n=94) and forensic (n=102) and psychiatric (n=199) patients completed the German versions of the Symptom Checklist Revised (SCL-90-R) and Brief Symptom Inventory (BSI). RESULTS In general, long-term prisoners showed the same level of mental distress as psychiatric patients and more than that reported by forensic patients. Short-term prisoners reported the least level of distress. Long- but not short-term prisoners showed clinically significant results on the scales for depression, paranoid ideation, and psychosis. CONCLUSIONS The improvements in psychiatric treatment for inmates demanded by many stakeholders need to differentiate between long- and short-term prisoners. Because depression seems to cause the most psychological distress among inmates, suicide prevention seems to be an important issue in prisons.
Collapse
Affiliation(s)
- S Otte
- Department of forensic psychiatry and psychotherapy, university of Ulm, Ulm, Germany.
| | - N Vasic
- Department of forensic psychiatry and psychotherapy, university of Ulm, Ulm, Germany
| | - S Nigel
- Department of forensic psychiatry and psychotherapy, university of Ulm, Ulm, Germany
| | - J Streb
- Department of forensic psychiatry and psychotherapy, university of Ulm, Ulm, Germany
| | - T Ross
- Department of forensic psychiatry and psychotherapy, centre for psychiatry Reichenau, Reichenau, Germany
| | - C Spitzer
- Asklepios hospital Tiefenbrunn, Rosdorf, Germany
| | - H J Grabe
- Department of psychiatry and psychotherapy, university of Greifswald, Greifswald, Germany
| | - M Dudeck
- Department of forensic psychiatry and psychotherapy, university of Ulm, Ulm, Germany
| |
Collapse
|
30
|
Association between schizophrenia and violence among Chinese female offenders. Sci Rep 2017; 7:818. [PMID: 28400569 PMCID: PMC5429758 DOI: 10.1038/s41598-017-00975-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/20/2017] [Indexed: 01/11/2023] Open
Abstract
Little is known about the association between schizophrenia and violence in women in China. This study aimed to examine the association between schizophrenia and violence in Chinese female offenders. Fifty-two schizophrenia patients were identified from the female offenders who received forensic psychiatric assessments in 2011 in Hunan province, China. Using a propensity score matching method, 104 matched controls without psychiatric disorders were selected from female criminals in Hunan province. Violent offences and homicides were verified and recorded. The percentages of violent offences and homicides were significantly higher in female offenders with schizophrenia than in controls (78.8% vs. 30.8%, P < 0.001; 44.2% vs. 18.3%, P = 0.001, respectively). Multivariate logistic regression analyses revealed that diagnosis of schizophrenia, younger age at first offence, living in rural area and a lower education level were independently and positively associated with violent offences, while having a diagnosis of schizophrenia and lower education level were associated with homicides. There appears to be an independent and positive association between schizophrenia and violent offence in Chinese female offenders. Effective preventive approaches on violence in female schizophrenia patients are warranted.
Collapse
|
31
|
Kageyama M, Solomon P, Yokoyama K. Psychological Distress and Violence Towards Parents of Patients with Schizophrenia. Arch Psychiatr Nurs 2016; 30:614-9. [PMID: 27654247 DOI: 10.1016/j.apnu.2016.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/05/2016] [Accepted: 02/13/2016] [Indexed: 11/15/2022]
Abstract
The present study investigated the relationship between violence and psychological distress experienced by parents of patients with schizophrenia. Questionnaire data from 379 parents were analyzed. A total of 151 parents (39.8%) had not experienced violence in the past year, whereas 96 (25.3%) and 132 (34.8%) had experienced psychological violence only or physical violence, respectively. A total of 216 (57.0%) of parents reported being psychologically distressed. Multiple logistic regression revealed that the risk of psychological distress significantly increased with the experience of psychological and physical violence, lower household income, greater family stigma, and the increasing age of patients.
Collapse
Affiliation(s)
- Masako Kageyama
- Department of Community Health Nursing, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Phyllis Solomon
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA.
| | - Keiko Yokoyama
- Department of Nursing, Faculty of Health Sciences, Saitama Prefectural University, Koshigaya City, Saitama, Japan.
| |
Collapse
|
32
|
Golenkov A, Large M, Nielssen O, Tsymbalova A. Homicide and mental disorder in a region with a high homicide rate. Asian J Psychiatr 2016; 23:87-92. [PMID: 27969086 DOI: 10.1016/j.ajp.2016.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 04/21/2016] [Accepted: 07/14/2016] [Indexed: 11/30/2022]
Abstract
There are few studies of the relationship between mental disorder and homicide offences from regions with high rates of homicide. We examined the characteristics and psychiatric diagnoses of homicide offenders from the Chuvash Republic of the Russian Federation, a region of Russia with a high total homicide rate. In the 30 years between 1981 and 2010, 3414 homicide offenders were the subjected to pre-trial evaluations by experienced psychiatrists, almost half of whom (1596, 46.7%) met the international classification of diseases (ICD) 10 criteria for at least one mental disorder. The six most common individual diagnoses were alcohol dependence (15.9%), acquired organic mental disorder (7.3%), personality disorder (7.1%), schizophrenia (4.4%) and intellectual disability (3.6%). More than one disorder was found in 7.4% of offenders and alcohol dependence was the most frequently diagnosed co-morbid disorder. One in ten offenders were found to be not criminally responsible for their actions. Few homicides involved the use of substances other than alcohol, and firearms were used in 1.6% of homicides. The finding that people with mental disorders other than psychosis committed a high proportion of homicides in a region with a high rate of homicide, suggests that people with mental disorders are vulnerable to similar sociological factors to those that contribute to homicide offences by people who do not have mental disorder.
Collapse
Affiliation(s)
- Andrei Golenkov
- Professor and Chair of Psychiatry and Medical Psychology, Chuvash State University, Cheboksary, Pirogov Street, 6, 428015, Russia.
| | - Matthew Large
- Conjoint Professor and Psychiatrist, Prince or Wales Hospital and University of New South Wales, Sydney, Australia
| | - Olav Nielssen
- Psychiatrist, Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, Australia
| | - Alla Tsymbalova
- Department of Judicial-Psychiatric Examination Republic Psychiatric Hospital, Cheboksary, Russia
| |
Collapse
|
33
|
Factors related to physical violence experienced by parents of persons with schizophrenia in Japan. Psychiatry Res 2016; 243:439-45. [PMID: 27450747 DOI: 10.1016/j.psychres.2016.06.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 11/22/2022]
Abstract
Most violence by patients with mental illness is perpetuated against family members rather than the general public. However, there is insufficient research to reach a consensus on factors related to family violence for this population. Thus, the current study aimed to clarify factors related to physical violence by patients with schizophrenia towards their parents in Japan. A self-administrated survey was distributed through family groups to families with a relative with a psychiatric disorder. Questionnaires completed by 400 parents of patients with schizophrenia were analyzed. Of the 400 parents, almost two-thirds experienced "no physical violence" and close to one-third experienced "physical violence" during the past year. Results of a mixed-effects logistic regression revealed that physical violence was significantly related to the patients' gender (female rather than male), multiple patient hospitalizations (3 or more times as compared to never hospitalized), low annual household income (less than US$20K as compared to over US$40K), and higher hostility and criticism of family interactions. Family violence maybe reduced through education on communication strategies for both parents and patients.
Collapse
|
34
|
Rezende Leal J, Martins Valença A. Fratricidio y esquizofrenia. ACTA ACUST UNITED AC 2016; 45:133-6. [DOI: 10.1016/j.rcp.2015.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/25/2015] [Accepted: 09/01/2015] [Indexed: 12/30/2022]
|
35
|
Karabekiroğlu A, Pazvantoğlu O, Karabekiroğlu K, Böke Ö, Korkmaz IZ. Associations with violent and homicidal behaviour among men with schizophrenia. Nord J Psychiatry 2016; 70:303-8. [PMID: 26634311 DOI: 10.3109/08039488.2015.1109139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective We aimed to assess the risk factors associated with homicidal behaviour in male patients diagnosed with schizophrenia. Methods In a period of 1 year, male schizophrenia cases between 18-65 years of age (n = 210) were included. The clinical evaluation included the Positive and Negative Syndrome Scale (PANSS) and Overt Aggression Scale (OAS). The patients were divided into three groups in terms of violent behaviour history: (1) homicide group (n = 30), (2) a violent act resulting in serious injury (n = 71), (3) control group (patients without a history of a violent act) (n = 109). Results Lower level of education, rural residence, being unemployed and living alone were found to be significantly more common in patients who had committed a violent act compared to the schizophrenia patients in the control group. In order to explore the predictive value of several factors associated with violent behaviour, a logistic regression model was used, and variables (shorter duration of education, living alone, and lack of insight) significantly predicted the presence of violent behaviour (murder and/or injury) (χ(2)=31.78, df = 12, p = 0.001). Conclusions In order to be able to determine causality of homicidal acts in schizophrenia patients, our significant findings between homicidal violence, non-homicidal violence and the control group would merit further attention and exploration in further studies.
Collapse
Affiliation(s)
- Aytül Karabekiroğlu
- a Department of Psychiatry , Training and Research Hospital , Samsun , Turkey
| | | | - Koray Karabekiroğlu
- c Department of Child and Adolescent Psychiatry , Ondokuz Mayis University Medical Faculty , Samsun , Turkey
| | - Ömer Böke
- d Department of Psychiatry , Ondokuz Mayis University Medical Faculty , Samsun , Turkey
| | | |
Collapse
|
36
|
Gazdag G, Belán E, Szabó FA, Ungvari GS, Czobor P, Baran B. Predictors of suicide attempts after violent offences in schizophrenia spectrum disorders. Psychiatry Res 2015; 230:728-31. [PMID: 26522825 DOI: 10.1016/j.psychres.2015.10.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 08/11/2015] [Accepted: 10/23/2015] [Indexed: 02/07/2023]
Abstract
The aim of this survey was to identify predictors of suicide attempts that immediately followed a violent crime in patients with schizophrenia. Documentations of patients diagnosed with schizophrenia and released in a 10 years period from the National Institute of Forensic Psychiatry were reviewed. Twenty-six out of 223 patients attempted suicide after the violent crime. The young age of the victim, and living in partnership were those factors differentiating suicidal violent offenders from their non-suicidal counterparts.
Collapse
Affiliation(s)
- Gábor Gazdag
- Centre for Psychiatry and Addiction Medicine, Szent István and Szent László Hospital, Gyáli út 17-19, 1097 Budapest, Hungary; Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
| | - Emese Belán
- Department of Neurology, Szent Imre Hospital, Budapest, Hungary
| | - Ferenc A Szabó
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Gabor S Ungvari
- Notre Dame University Australia, Perth, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Pál Czobor
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Brigitta Baran
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| |
Collapse
|
37
|
Kageyama M, Yokoyama K, Nagata S, Kita S, Nakamura Y, Kobayashi S, Solomon P. Rate of Family Violence Among Patients With Schizophrenia in Japan. Asia Pac J Public Health 2015; 27:652-60. [PMID: 26182940 DOI: 10.1177/1010539515595069] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Family violence is a serious concern in the era of deinstitutionalization in Japan. Consequently, we aimed to clarify the rate of family violence among patients with schizophrenia, and differences by sex and relationship to the patient. We asked households belonging to a family group association to complete a self-administered mail survey. Of 350 households that responded, data for 302 were analyzed. The rate of violence toward any family member was 60.9% over the lifetime and 27.2% in the past year. Order of lifetime rates for family members from highest to lowest was 51.0% for mothers, 47.0% for fathers, 30.7% for younger sisters, 23.8% for spouses, 19.5% for younger brothers, 18.2% for older sisters, 17.1% for older brothers, and none for children. Younger sisters were more likely to be victims compared to other siblings. Fathers and older brothers were likely to be victims when patients were male.
Collapse
Affiliation(s)
| | | | | | | | - Yukako Nakamura
- Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | |
Collapse
|
38
|
Van Dongen JDM, Buck NML, Barendregt M, Van Beveren NM, De Beurs E, Van Marle HJC. Anti-social personality characteristics and psychotic symptoms: Two pathways associated with offending in schizophrenia. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2015; 25:181-191. [PMID: 25078287 DOI: 10.1002/cbm.1923] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/22/2014] [Accepted: 06/03/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Several research groups have shown that people with schizophrenia who offend do not form a homogenous group. A three-group model claimed by Hodgins proposes distinguishing between people who start offending before the onset of psychosis (early starters), after psychosis onset but at age 34 years or under (late starters) and after psychosis onset but at age 35 years or older (late first offenders). AIMS This study aimed to test the hypotheses (1) that the personality of early starters and non-psychotic offenders would be similar, but different from either late-starter group; (2) that the late-starter groups would be more likely to have positive psychotic symptoms than non-criminal patients with schizophrenia; and (3) that symptom types would differentiate the psychotic groups. METHODS A retrospective file study was conducted on cases of 97 early starters, 100 late starters and 26 late first offenders all drawn from the Netherlands Institute of Forensic Psychiatry and Psychology (NIFP) archives 1993-2008, 115 non-psychotic offenders from 2005-2008 NIFP archives and 129 patients with schizophrenia and no criminal history from one general service in Rotterdam. RESULTS Early starters closely resembled the non-psychotic offenders in their premorbid anti-social personality characteristics. The two late-onset offending psychosis groups were more likely to have persecutory and/or grandiose delusions than non-offenders with psychosis, but so were the early starters. IMPLICATIONS In a first study to compare subgroups of offenders with psychosis directly with non-psychotic offenders and non-offenders with psychosis, we found such additional support for a distinction between early and late starters with psychosis that different treatment strategies would seem indicated, focusing on personality and substance misuse for the former but psychotic symptoms for all. It remains to be seen whether the higher rate of alcohol misuse amongst late first offenders is a fundamental distinction or a function of age difference.
Collapse
Affiliation(s)
- Josanne D M Van Dongen
- Department of Forensic Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
- Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Nicole M L Buck
- Department of Forensic Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
- Forensic Psychiatric Center De Kijvelanden, Rhoon, The Netherlands
| | - Marko Barendregt
- Department of Research & Development, Netherlands Institute for Forensic Psychiatry and Psychology (NIFP), Utrecht, The Netherlands
- Foundation Benchmark GGZ, Bilthoven, The Netherlands
| | - Nico M Van Beveren
- Department of Forensic Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
- Delta Psychiatric Center, Poortugaal, The Netherlands
| | - Edwin De Beurs
- Department of Research & Development, Netherlands Institute for Forensic Psychiatry and Psychology (NIFP), Utrecht, The Netherlands
- Foundation Benchmark GGZ, Bilthoven, The Netherlands
| | - Hjalmar J C Van Marle
- Department of Forensic Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
39
|
Chen SC, Chu NH, Hwu HG, Chen WJ. Trajectory classes of violent behavior and their relationship to lipid levels in schizophrenia inpatients. J Psychiatr Res 2015; 66-67:105-11. [PMID: 26004299 DOI: 10.1016/j.jpsychires.2015.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 04/25/2015] [Accepted: 04/29/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To characterize the trajectory patterns of violence in schizophrenia inpatients, examine the relationships between the violence trajectories and baseline clinical features and lipid levels, and generate a model to predict the more violent trajectories. METHODS In a sample of 107 consecutively admitted patients with schizophrenia spectrum disorders, violent behavior was weekly rated using the Violence Scale. The patients' blood levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured at admission. A trajectory analysis was used to classify the patients' longitudinal courses in violence, and the correlates of these trajectories were assessed using multinomial logistic regression analyses. A stepwise logistic regression was used to select the best predictor variables for the more violent trajectories. RESULTS Four violence trajectories of inpatients were obtained: class 1 (no violence, 37.4%), class 2 (low-leveling off, 39.2%), class 3 (high-falling sharply, 10.3%), and class 4 (high-falling slowly, 13.1%). Although the relationship between decreasing TC and TG levels and increased violence in the trajectory classes did not reach statistical significance, a decreasing trend in the proportion of high dichotomized-TG levels was significantly associated with more violence in the trajectory classes (p = 0.04). A five-variable model consisting of female gender, early onset, higher scores of positive symptoms, lower scores of negative symptoms, and low dichotomized-TC levels had a predictive accuracy of 0.85 (95% CI = 0.72-0.97). CONCLUSIONS Distinct violence trajectories exist in schizophrenia inpatients, and the more violent trajectories can be predicted using baseline clinical features and lipid levels.
Collapse
Affiliation(s)
- Shing-Chia Chen
- School of Nursing, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei 100, Taiwan
| | - Ni-Hsuan Chu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | - Hai-Gwo Hwu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan.
| |
Collapse
|
40
|
Skeie CA, Rasmussen K. Assessment of causal associations between illness and criminal acts in those who are acquitted by reason of insanity. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:327-30. [PMID: 25707655 DOI: 10.4045/tidsskr.13.0904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The court proceedings after the terrorist attacks on 22 July 2011 reignited the debate on the justification for having a rule that regulates the insanity defence exclusively on the basis of a medical condition – the medical principle. The psychological principle represents an alternative that requires a causal relationship between the psychosis and the acts committed. In this article we investigate rulings made by the courts of appeal where the accused have been found legally insane at the time of the act, and elucidate the extent to which a causal relationship between the illness and the act appears to be in evidence. MATERIAL AND METHOD Data have been retrieved from rulings by the courts of appeal published at lovdata.no, which include anonymised rulings. Searches were made for cases under Section 39 (verdict of special sanctions) and Section 44 (acquittal by reason of insanity) of the General Civil Penal Code. Court rulings in which a possible causal relationship could be considered were included. The included rulings were carefully assessed with regard to whether a causal relationship existed between the mental disorder of the accused at the time and the criminal act. The search returned a total of 373 rulings, of which 75 were included. RESULTS The vast majority of the charges referred to serious crimes. Diagnoses under ICD-10 category codes F20-29 (schizophrenia, schizotypal and delusional disorders) were the most frequently occurring type. In 17 of the 75 rulings (23%), it was judged that no causal relationship between the illness and the act existed. In 25 of 26 cases that involved homicide, a causal relationship between the illness and the act was judged to be evident. INTERPRETATION The data may indicate that the medical principle results in impunity in a considerable number of rulings where the illness of the accused apparently has had no effect on the acts committed.
Collapse
Affiliation(s)
| | - Kirsten Rasmussen
- Kompetansesenteret for sikkerhets-, fengsels- og rettspsykiatri, Brøset og Psykologisk institutt Norges teknisk-naturvitenskapelige universitet
| |
Collapse
|
41
|
Bouhlel S, Nakhli J, Ben Meriem H, Ridha R, Ben Hadj Ali B. Les facteurs liés aux actes d’homicide chez les patients tunisiens atteints de schizophrénie. EVOLUTION PSYCHIATRIQUE 2014. [DOI: 10.1016/j.evopsy.2013.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
42
|
Abstract
BACKGROUND Violent behaviour can be a presenting sign of first-episode psychosis. Duration of untreated psychosis (DUP) has been a focus of attention because it is a potentially modifiable factor that may influence outcome. AIMS The aim was to review the literature addressing the following issues: prevalence of violence or aggression in the first episode of psychosis, violence or aggression during the periods before and after the initiation of treatment, the DUP and relation between DUP and the level of violence or aggression in first-episode psychosis. METHODS MEDLINE and PubMed databases were searched for articles using the combination of key words 'aggression' (limited to humans) and 'first episode' and 'psychosis'. RESULTS Available evidence suggests that the prevalence of violent behaviour in the first episode of psychosis, particularly schizophrenia, is greater than during the later stages of the illness. First-episode psychosis is associated with an increased risk of homicide. There is some limited support for an effect of DUP length on serious violence or aggression. Violent behaviour frequently develops before the onset of first episode. Substance use disorders are additional factors that elevate the risk for violence in these patients. CONCLUSIONS Earlier treatment of first episode psychosis might prevent some homicides. Personality factors and substance abuse may be more important than psychotic symptoms in the development of aggressive behaviour in patients with first-episode psychosis.
Collapse
Affiliation(s)
- K Látalová
- Psychiatric Department, Palacký University, Olomouc, Czech Republic
| |
Collapse
|
43
|
Golenkov A, Nielssen O, Large M. Systematic review and meta-analysis of homicide recidivism and schizophrenia. BMC Psychiatry 2014; 14:46. [PMID: 24548381 PMCID: PMC3933385 DOI: 10.1186/1471-244x-14-46] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 02/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the proportion of homicide recidivists among population studies of homicide offenders with schizophrenia. METHODS Systematic review and meta-analysis of published studies of homicide associated with schizophrenia conducted in defined populations and indexed in Medline, PsychINFO, or Embase between January 1960 and November 2013. Published data was supplemented with unpublished data about recidivism obtained by personal communication from the authors of published studies of homicide and schizophrenia. Random effects meta-analysis was used to calculate a pooled estimate of the proportion of homicide recidivists. RESULTS Three studies reported that 4.3%, 4.5%, and 10.7% of homicide offenders with schizophrenia had committed an earlier homicide. Unpublished data were obtained from the authors of 11 studies of homicide in schizophrenia published in English between 1980 and 2013. The authors of 2 studies reported a single case of homicide recidivism and the authors of 9 studies reported no cases. The rates of homicide recidivism between studies were highly heterogeneous (I-square = 79). The pooled estimate of the proportion of homicide offenders with schizophrenia who had committed an earlier homicide was 2.3% (95% CI (Confidence Interval) 0.07% to 7.2%), a figure that was not reported in any individual study. The pooled proportion of homicide recidivists from published reports was more than ten times greater (8.6%, 95% CI 5.7%-12.9%) than the pooled proportion of homicide recidivists estimated from data provided by personal communication (0.06%, 95% CI 0.02% to 1.8%). CONCLUSIONS In most jurisdictions, homicide recidivism by people with schizophrenia is less common than published reports have suggested. The reasons for the variation in the rates of homicide recidivism between studies are unclear, although in most jurisdictions long-term secure treatment and supervision after release appears to be effective in preventing homicide recidivism. A prospective study conducted in a large population or in multiple jurisdictions over a long period of time might result in a more accurate estimate the risk of a second homicide by a person with schizophrenia.
Collapse
Affiliation(s)
- Andrei Golenkov
- Psychiatry and Medical Psychology, Chuvash State University, Cheboksary, Russia
| | - Olav Nielssen
- University of New South Wales, Sydney, Australia,Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Sydney, Australia
| | | |
Collapse
|
44
|
Abstract
Most individuals diagnosed with a mental illness are not violent, but some mentally ill patients commit violent acts. PubMed database was searched for articles published between 1980 and November 2013 using the combination of key words “schizophrenia” or “bipolar disorder” with “aggression” or “violence.” In comparison with the general population, there is approximately a twofold increase of risk of violence in schizophrenia without substance abuse comorbidity and ninefold with such comorbidity. The risk in bipolar disorder is at least as high as in schizophrenia. Most of the violence in bipolar disorder occurs during the manic phase. Violence among adults with schizophrenia may follow two distinct pathways: one associated with antisocial conduct and another associated with the acute psychopathology, particularly anger and delusions. Clozapine is the most effective treatment of aggressive behavior in schizophrenia. Emerging evidence suggests that olanzapine may be the second most effective treatment. Treatment nonadherence greatly increases the risk of violent behavior, and poor insight as well as hostility is associated with nonadherence. Nonpharmacological methods of treatment of aggression in schizophrenia and bipolar disorder are increasingly important. Cognitive behavioral approaches appear to be effective in cases where pharmacotherapy alone is not sufficient.
Collapse
|
45
|
Large M, Golenkov A, Nielssen O. Fear of the (almost) unknown. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2014; 24:1-4. [PMID: 24501076 DOI: 10.1002/cbm.1895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/22/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Matthew Large
- Prince of Wales Hospital, Sydney, Australia; University of New South Wales, Sydney, Australia
| | | | | |
Collapse
|
46
|
Psychotic symptoms, self-harm and violence in individuals with schizophrenia and substance misuse problems. Schizophr Res 2013; 151:215-20. [PMID: 24268935 DOI: 10.1016/j.schres.2013.10.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/16/2013] [Accepted: 10/25/2013] [Indexed: 11/21/2022]
Abstract
When schizophrenia is combined with substance misuse, rates are consistently higher. However research findings on the relationship between violence, self-harm and schizophrenia are inconclusive. This study aimed to examine links between specific psychotic symptoms, substance misuse and violence in people dually diagnosed with schizophrenia and substance misuse. Presence and frequency of violence to self and others were examined in relation to the type and severity of psychotic symptoms and level of substance use over a 24 month period in 327 people with schizophrenia and substance misuse problems. 32.3% had an incident of violence to others during the study period and 28.6% had a self-harm/suicide incident. 39 (11.9%) participants reported command hallucinations (CH) and 157 (48.0%) had threat control override symptoms (TCOS). Presence of TCOS and presence of CH were not associated with violence to others but were both associated with self-harm. Different command hallucination sub-types were associated with different types of violence. Delusional and hallucination severity and distress were mainly associated with self-harm. These findings suggest that specific symptoms are related to different outcomes, particularly in relation to self-harm, and these effects remain even after substance use is controlled for. This has important implications for assessment and treatment of this group.
Collapse
|
47
|
Schutte T, Subramaney U. 'Single' v. 'panel' appointed forensic mental observations: Is the referral process ethically justifiable? SOUTH AFRICAN JOURNAL OF BIOETHICS AND LAW 2013; 6:64-68. [PMID: 25705352 PMCID: PMC4335650 DOI: 10.7196/sajbl.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To compare the outcome and psychiatric morbidity of the forensic mental observation referrals, in the two legally created groups of detainees awaiting trial - the 'singles', representing the minor violent and non-violent offenders evaluated by a single-state appointed psychiatrist, v. the 'panels', representing the seriously violent offenders evaluated by two or more psychiatrists. METHODS A retrospective record review covered 200 cases, comprising all individuals admitted to the forensic unit of Sterkfontein Hospital for 30 days psychiatric observation from January to August 2010. Pearson's χ2 test for categorical data were used to determine statistical significance. RESULTS Of 110 singles, 49 (44.55%) were found fit for trial and 40 (40.4%) were found criminally responsible. Of the 90 'panel' cases 60 (66.67%) were found ft for trial and 57 (64.77%) were found criminally responsible (p=0.002 and p=0.001, respectively). CONCLUSION Those charged with seriously violent offences appear more likely to be found both fit and responsible, compared with those charged with less serious offences.
Collapse
Affiliation(s)
- T Schutte
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - U Subramaney
- Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
48
|
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.
Collapse
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.
| | | | | | | | | | | |
Collapse
|
49
|
Abstract
BACKGROUND Mania has been reported to be a risk factor for aggression and violence in psychiatric hospitals, but the extent of any association between mania and severe interpersonal violence in community settings is not known. AIM To examine the association between mania and severe violence in a series of patients found not guilty by reason of mental illness (NGMI). METHODS A review of the court documents of those found NGMI of offences involving severe violence, including homicide, attempted homicide and assault causing wounding or serious injury, in New South Wales between 1992 and 2008. RESULTS Twelve of 272 people found NGMI were in a manic state when they committed a severe violence offence. Ten were diagnosed with schizo-affective disorder and two with bipolar disorder. Three patients were in the depressed phase of schizo-affective disorder and there were no patients in the depressed phase of bipolar disorder. CONCLUSION Mania, in particular the manic phase of bipolar disorder, is not strongly associated with severe violence.
Collapse
Affiliation(s)
- Olav B Nielssen
- 1Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Darlinghurst, Sydney, Australia
| | | | | |
Collapse
|
50
|
Homicide and bipolar I disorder: A 22-year study. Forensic Sci Int 2012; 217:113-8. [DOI: 10.1016/j.forsciint.2011.10.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 07/22/2011] [Accepted: 10/18/2011] [Indexed: 10/15/2022]
|