Untreated Schizophrenia Raises Risk of Violence, Study Finds

A study that tracked released prisoners convicted of violent crimes found that mental health treatment affected rates of subsequent violence among those with schizophrenia. Most of the 967 prisoners in the study had no psychosis at about nine months after their release. However, 94 were diagnosed with schizophrenia, 29 with a delusional disorder, and 102 with drug-induced psychosis.

After adjusting for demographic factors, psychiatric comorbidities, and substance use, former prisoners whose schizophrenia was untreated during or after imprisonment were found to be three times more likely to be violent after their release than were prisoners who received psychosis treatment or those without psychosis, wrote Robert Keers, Ph.D., of Queen Mary University of London, and colleagues, online today in AJP in Advance. The presence of persecutory delusions appeared to explain at least part of that association, they said.

“[O]ur findings are consistent with those in studies of treatment compliance in psychosis that report that nonadherence to medication is associated with increased risk of violence,” the researchers said. “They are also in line with findings from studies of first-episode patients that suggest that the risk of violence is higher at first presentation than following treatment.”

The fact that a prisoner was untreated for psychosis should be considered a risk factor for violent recidivism, they concluded.

To read more about early detection and treatment of schizophrenia, see the Psychiatric News column "Early Detection of Schizophrenia: The Time Is Now." Also see the book Essentials of Schizophrenia from American Psychiatric Publishing.

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