Citation

Appelbaum PS. Am. J. Psychiatry 2019; 176(9): 677-679.

Affiliation

The Center for Law, Ethics, and Psychiatry, Department of Psychiatry, Columbia University, New York.

Copyright

(Copyright © 2019, American Psychiatric Association)

DOI

10.1176/appi.ajp.2019.19070678

PMID

31474122

Abstract

What do we know about the relationship between violence and schizophrenia? Violence is more common among people with schizophrenia than among people without mental disorders, roughly twice as frequent when controlling for the substantial effects of comorbid substance abuse (1). A large number of variables have been associated with this increased risk of violence, with the more robust including younger age, previous violence, antisocial traits, and medication nonadherence (2). Although risk prediction models appear to be able to identify subgroups of people with mental disorders who are at higher risk for violence, there is little evidence with regard to the accuracy of predictions for people with schizophrenia per se (3) and reasons to believe that there may be inherent limits on the precision of individual predictions (4).

Hence, notwithstanding the hundreds of studies of violence in schizophrenia and other psychoses over the past half century, psychiatrists faced with clinical, legal, and societal pressures to identify patients who are likely to engage in violent behavior remain in need of additional assistance to accomplish this task. It is precisely this need that motivates studies like the one by Buchanan et al. (5) in this ...

Language: en

Keywords

Schizophrenia; Violence/Aggression