Homicidal behaviors among psychiatric outpatients.
OBJECTIVE
Most studies of violent behavior among psychiatric patients focus on inpatients or patients recently discharged from psychiatric units. To explore violent behavior among patients living in the community, the authors examined the prevalence of homicidal behaviors in a general psychiatric outpatient population.


METHODS
During an intake evaluation, 517 outpatients completed several self-report instruments that included a detailed survey of past and current homicidal behaviors covering homicidal ideation, plans, and attempts. Demographic and clinical characteristics of patients with and without a history of homicidal behaviors were compared.


RESULTS
Twenty-two patients (4 percent) reported a past homicide attempt. Patients who reported homicide attempts could be distinguished from patients with no homicidal behaviors by the presence of other aggressive behavior such as suicidal ideation and suicide attempts by themselves and their family members and by elevated current measures of interpersonal sensitivity, hostility, and paranoid ideation.


CONCLUSIONS
The rate of homicide attempts in the general outpatient population studied was considerably lower than the reported rates of assault among inpatients. The relationship between past and current episodes of aggressive behavior reinforces the importance of including a careful assessment of past history of violent behaviors as part of the routine psychiatric evaluation.
Asnis
G M
GM
Department of Psychiatry, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, New York 10467.
Kaplan
M L
ML
van Praag
H M
HM
Sanderson
W C
WC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003617:Dangerous Behavior; D005260:Female; D006708:Homicide / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010555:Personality Inventory; D012307:Risk Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D014754:Violence