Study Takes Closer Look at Violence Targeting People With Psychiatric Disorders

A study appearing today in JAMA Psychiatry found that fewer than 7% of patients with psychiatric disorders in Sweden had either been subjected to violence severe enough to require specialist medical treatment or had perpetrated violence.

Amir Sariaslan, Ph.D., of the University of Oxford and colleagues identified 250,419 individuals from Sweden’s National Patient Register who were born between 1973 and 1993 and had been diagnosed psychiatric disorders. Psychiatric disorders included anxiety disorders, depression, bipolar disorder, schizophrenia, personality disorders, alcohol use disorder, and drug use disorder. The patients were matched by age and sex to individuals in the general population (n = 2,504,190) and to their full biological siblings who did not have psychiatric disorders (n = 194,788).

The researchers tracked whether these patients were subjected to violence (defined as an outpatient visit, inpatient episode, or death associated with an injury purposefully inflicted by other persons) or perpetuated violence (defined as a violent crime conviction) until they migrated, died, or reached the end of the study period on December 31, 2013. Data on convictions were pulled from Sweden’s National Crime Register.

Compared with the general population, patients with psychiatric disorders were more likely to be subjected to violence and to perpetrate violence, the authors found. Patients with psychiatric disorders were three to four times more likely than their siblings without psychiatric disorders to be either subjected to violence or perpetrate violence.

The researchers also found that “the risks of subjection to and perpetration of violence varied across specific psychiatric disorders and were highest in persons with substance use disorders.” After adjusting for comorbid substance use disorders and personality disorders, they added, those diagnosed with schizophrenia “were no more likely than their siblings without psychiatric disorders to be subjected to violence.”

In an accompanying editorial, past APA President Paul S. Appelbaum, M.D., noted that the data on patients targeted by violence may be incomplete as many may not have sought medical attention

“Although violence perpetrated by people with mental disorders accounts for only a small proportion of violent incidents, to the extent that the frequency of such events can be diminished, people with the potential to be targeted by violence and incipient perpetrators will benefit,” Appelbaum wrote. He added that reducing the likelihood that someone with a mental disorder will be the target of violence “will benefit them directly and is likely to make it easier for them to reintegrate into the community.”

For related information, see the Psychiatric News article “Former APA President Calls for New Paradigm for Studying Violence, Mental Illness.”

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