Article1998

Mental disorder and violence

Pamela J. Taylor · Morven Leese · Deborah Williams · Martin Butwell · Rachel Louise Daly · Emmet P. Larkin

251 citations0/0 files storedThe British Journal of Psychiatry

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Psychopathy, Forensic Psychiatry, Sexual Offending Schizophrenia research and treatment Crime Patterns and Interventions

Abstract

BACKGROUND: From a first clinical description of a complete resident sample of special (high security) hospital patients, we examined the association between mental disorder and violence. METHOD: A record survey of all 1740 patients resident at any time between 1 January and 30 June 1993, inclusive, and, for most, the official criminal record. RESULTS: 1015 patients (58%) had functional psychosis, one-quarter of whom also had an independent personality disorder; 461 (26%) had personality disorders uncomplicated by psychosis, and 264 (16%) had learning disabilities. Pre-admission substance misuse, which was probably under-recorded, had been most common among those with psychosis and an independent personality disorder. Less than 10% had never been convicted of a criminal offence, although 25% had been admitted directly from other hospitals. Direct personal violence was more common among men, and fire-setting among women. Schizophrenia was most strongly associated with personal violence. More than 75% of those with a psychosis were recorded as being driven to offend by their delusions. In the absence of delusions, hallucinations had no such effect. CONCLUSIONS: For people with personality disorder better clinical descriptions seem essential. For people with a pure psychosis, as symptoms were usually a factor driving the index offence, treatment appears as important for public safety as for personal health.

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References

1994Violence and mental disorder: developments in risk assessment 1990Violence and Psychiatric Disorder in the Community: Evidence From the Epidemiologic Catchment Area Surveys 1992Mental Disorder, Intellectual Deficiency, and Crime 1996Mental Disorder and Crime 1993The Accuracy of Predictions of Violence to Others 1991Treatment needs of prisoners with psychiatric disorders.1994Psychotic Symptoms and the Violent/Illegal Behavior of Mental Patients Compared to Community Controls 1996Psychotic symptoms and disorders and the risk of violent behaviour in the community

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2002Mental Disorder and Violence: Personality Dimensions and Clinical Features 2006Volumetric structural brain abnormalities in men with schizophrenia or antisocial personality disorder 2011Risk factors for violence among patients with schizophrenia 2000Psychopathy (PCL-R) as a predictor of violent recidivism among criminal offenders with schizophrenia.2001Characteristics of violent behaviour in acute psychiatric in-patients: a 5-year Italian study

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