title: Violent victimization of persons with co-occurring psychiatric and substance use disorders.
abstract: OBJECTIVE
  This study examined the frequency with which persons in the community with psychiatric disorders, substance use disorders, and both types of disorders are victims of violence.
  
  
  METHODS
  The relationship between diagnosis, gender, and victimization over a one-year period was examined in two cross-sectional data sets, one drawn from a study of adaptation to community life of persons with severe mental illness in Connecticut (N=109) and the other drawn from assessments made by caseworkers in a Connecticut outreach project for persons with psychiatric and substance use disorders (N=197). Analysis of variance was used to evaluate the frequency of victimization across diagnostic categories in each data set.
  
  
  RESULTS
  People with co-occurring psychiatric and substance use disorders had significantly more episodes of victimization than those with either a psychiatric or a substance use disorder only. Gender was not associated with victimization. Qualitative data from focus groups indicated that social isolation and cognitive deficits leading to poor judgment about whom to trust may leave people with serious mental illness vulnerable to drug dealers.
  
  
  CONCLUSIONS
  Social environmental mechanisms, such as exploitation by drug dealers, may play an important role in maintaining victimization among persons with co-occurring disorders.
authors.affiliation: Department of Psychiatry, Program for Recovery and Community Health, Yale University School of Medicine, Suite 306, New Haven, CT 06511, USA. david.sells@yale.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Sells
authors.forename: Michael
authors.initials: M
authors.lastname: Rowe
authors.forename: Deborah
authors.initials: D
authors.lastname: Fisk
authors.forename: Larry
authors.initials: L
authors.lastname: Davidson
mesh_terms: D000328:Adult; D003237:Connecticut / Q000453:epidemiology; D019548:Crime Victims / Q000523:psychology*; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D014754:Violence / Q000706:statistics & numerical data*