The social-environmental context of violent behavior in persons treated for severe mental illness.
OBJECTIVE
This study examined the prevalence and correlates of violent behavior by individuals with severe mental illness.


METHODS
Participants (N = 802) were adults with psychotic or major mood disorders receiving inpatient or outpatient services in public mental health systems in 4 states.


RESULTS
The 1-year prevalence of serious assaultive behavior was 13%. Three variables-past violent victimization, violence in the surrounding environment, and substance abuse-showed a cumulative association with risk of violent behavior.


CONCLUSIONS
Violence among individuals with severe mental illness is related to multiple variables with compounded effects over the life span. Interventions to reduce the risk of violence need to be targeted to specific subgroups with different clusters of problems related to violent behavior.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. swanson@duke.edu
Jeffrey W
JW
Swanson
Marvin S
MS
Swartz
Susan M
SM
Essock
Fred C
FC
Osher
H Ryan
HR
Wagner
Lisa A
LA
Goodman
Stanley D
SD
Rosenberg
Keith G
KG
Meador
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000150:complications*; D015897:Comorbidity; D003237:Connecticut / Q000453:epidemiology; D019548:Crime Victims; D003617:Dangerous Behavior; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D011336:Probability; D011618:Psychotic Disorders / Q000150:complications*; D011635:Public Health Administration; D012931:Social Environment; D014754:Violence / Q000208:ethnology / Q000706:statistics & numerical data*