Predicting violence in schizophrenia: a prospective study.
BACKGROUND
People with schizophrenia are more violent than the general population, but this increased risk is attributable to the actions of a small subgroup. Identifying those at risk has become an essential part of clinical practice.


OBJECTIVE
To estimate the risk factors for assault in patients with schizophrenia.


METHODS
Two hundred seventy-one patients with schizophrenia were interviewed using an extensive battery of instruments. Assault was measured from multiple data sources over the next 2 years and criminal records were obtained. Multiple sociodemographic and clinical variables measured at baseline were examined as possible predictors of assault during follow-up.


RESULTS
Sixty-nine (25%) patients committed assault during the 2-year follow-up. The model that best predicted assault included a history of recent assault (OR 2.33, 95% CI 1.17-4.61), a previous violent conviction (OR 2.02, 95% CI 1.04-3.87), having received special education (OR 2.76, 95% CI 1.22-6.26) and alcohol abuse (OR 3.55, 95% CI 1.24-10.2).


CONCLUSIONS
Previously established risk factors including a history of violence and alcohol abuse are replicated in this study. Although low premorbid IQ did not predict violence, a need for special education did.
Section of Forensic Mental Health, Guy's, King's and St. Thomas's School of Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. sppmemw@iop.kcl.ac.uk
Elizabeth
E
Walsh
Catherine
C
Gilvarry
Chiara
C
Samele
Kate
K
Harvey
Catherine
C
Manley
Theresa
T
Tattan
Peter
P
Tyrer
Francis
F
Creed
Robin
R
Murray
Thomas
T
Fahy
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000374:Aggression; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D014754:Violence