Violent behavior and DSM-IV psychiatric disorders: results from the national epidemiologic survey on alcohol and related conditions.
OBJECTIVE
To present nationally representative data on the lifetime prevalence and population estimates of violent behavior among individuals with DSM-IV psychiatric disorders.


METHODS
The data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Prevalences, population estimates, and associations of violent behavior occurring among individuals with pure, comorbid, and specific DSM-IV psychiatric disorders were examined.


RESULTS
After controlling for sociodemographic characteristics and other comorbidity, it was found that the odds of violent behavior were significantly increased (p < .05) among individuals with substance use disorders; pathological gambling; major depressive disorder; bipolar disorders; panic disorder without agoraphobia; specific phobia; and paranoid, schizoid, histrionic, and obsessive-compulsive personality disorders. Percentages of violent behavior among individuals with each comorbid disorder were, with few exceptions, significantly greater (p < .05-p < .001) than the corresponding percentages among those presenting with the pure form of each disorder. Alcohol and drug use disorders were the most significant contributors to the public health burden of violent behavior.


CONCLUSIONS
The majority of individuals with psychiatric disorders do not engage in violent behavior, and public perception associated with stereotypic violence among individuals with psychiatric disorders appears unwarranted. Elevated risks and burden of violent behavior were not equally shared across the spectrum of psychiatric disorders, with particular disorders, especially substance use disorders, contributing disproportionately to the burden. Future research should examine the circumstances under which violence among individuals with psychiatric disorders occurs with a view toward improving clinical prediction and developing more effective prevention strategies.
Pulay
Attila J
AJ
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, Md. 20892-9304, USA.
Dawson
Deborah A
DA
Hasin
Deborah S
DS
Goldstein
Risë B
RB
Ruan
W June
WJ
Pickering
Roger P
RP
Huang
Boji
B
Chou
S Patricia
SP
Grant
Bridget F
BF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*