Delusions Plus Anger Leads Some to Violence

Are people with psychiatric delusions likely to become violent? To get the answer, researchers looked at 458 patients who had entered treatment for the first episode of a psychotic disorder. Most of the patients (62 percent) were not violent in the year prior to the study. However, 26 percent did engage in minor violence and 12 percent in serious violence, reported Simone Ullrich, Ph.D., of Queen Mary University of London, and colleagues, March 6 in JAMA Psychiatry online.

“Only three delusions demonstrated significant associations with serious violence,” the authors said. However, the violence was not attributable to the delusions alone but to the interaction of delusions and anger.

"Delusions of being spied on, persecution, and conspiracy were significantly mediated by anger due to delusions in their relationship with serious violence,” they said. “A subset of delusional beliefs appeared to lead to ‘tense situations,’ which are described as an important component in a causal model of mental illness and violence.”

Anger that is a reaction to delusional beliefs may be susceptible to treatment that targets anger, said the researchers. But anger intrinsic to the delusion would suggest that treatment must target the delusion and the associated anger at the same time.

To read more about research on anger and aggression, see Psychiatric News  here.

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