Alcohol abuse as the strongest risk factor for violent offending in patients with paranoid schizophrenia.
OBJECTIVE
To determine predictive risk factors for violent offending in patients with paranoid schizophrenia in Croatia.


METHODS
The cross-sectional study including male in-patients with paranoid schizophrenia with (N=104) and without (N=102) history of physical violence and violent offending was conducted simultaneously in several hospitals in Croatia during one-year period (2010-2011). Data on their sociodemographic characteristics, duration of untreated illness phase (DUP), alcohol abuse, suicidal behavior, personality features, and insight into illness were collected and compared between groups. Binary logistic regression model was used to determine the predictors of violent offending.


RESULTS
Predictors of violent offending were older age, DUP before first contact with psychiatric services, and alcohol abuse. Regression model showed that the strongest positive predictive factor was harmful alcohol use, as determined by AUDIT test (odds ratio 37.01; 95% confidence interval 5.20-263.24). Psychopathy, emotional stability, and conscientiousness were significant positive predictive factors, while extroversion, pleasantness, and intellect were significant negative predictive factors for violent offending.


CONCLUSIONS
This study found an association between alcohol abuse and the risk for violent offending in paranoid schizophrenia. We hope that this finding will help improve public and mental health prevention strategies in this vulnerable patient group.
Marija Kudumija Slijepcevic, Department of Psychiatry, General Hospital Bjelovar, 43000 Bjelovar, Croatia, mkudumija@gmail.com.
Marija
M
Kudumija Slijepcevic
Vlado
V
Jukic
Darko
D
Novalic
Tija
T
Zarkovic-Palijan
Milan
M
Milosevic
Ivana
I
Rosenzweig
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D017523:Croatia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012563:Schizophrenia, Paranoid / Q000523:psychology*; D014754:Violence / Q000523:psychology*; D055815:Young Adult