Risk for violence perpetration up for people with schizophrenia

(HealthDay)—Individuals with schizophrenia spectrum disorders have an increased risk for perpetrating violent outcomes compared with community controls, according to a review and meta-analysis published online Dec. 22 in JAMA Psychiatry.

Daniel Whiting, B.M., B.Ch., from the University of Oxford in the United Kingdom, and colleagues conducted a systematic review and meta-analysis to examine the risk for perpetrating interpersonal violence in individuals with schizophrenia spectrum disorders compared with general population controls. Data were included from 24 studies of violence perpetration outcomes in 15 countries over four decades, with 51,309 individuals with schizophrenia spectrum disorders.

The researchers found that in men with schizophrenia and other psychoses, there was an increase in the risk for violence perpetration (pooled odds ratio, 4.5); substantial heterogeneity was seen (I² = 85 percent). In women, the risk was also elevated (pooled odds ratio, 10.2), with considerable heterogeneity (I² = 66 percent). Increased odds of perpetrating sexual offenses and homicides were also seen (odds ratios, 5.1 and 17.7, respectively). In register-based studies, the absolute risks for violence perpetration were less than one in 20 and less than one in four for women and men with schizophrenia spectrum disorders, respectively, during a 35-year period.

"Prevention of violence perpetration should be a target for clinical services that assess and treat individuals with these disorders," the authors write. "New work should consider preventive approaches, including the improvement of the clinical assessment of risk and targeted resource allocation to treat modifiable factors."

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