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. 2018 Oct 23:14:2793-2805.
doi: 10.2147/NDT.S167928. eCollection 2018.

Violence in persons with and without psychosis in the Czech Republic: risk and protective factors

Martin Černý  1   2 , Sheilagh Hodgins  3 , Radmila Kučíková  2   4 , Ladislav Kážmér  5 , Alena Lambertová  1 , Alexander Nawka  1 , Lucie Nawková  1 , Anna Parzelka  1 , Jiří Raboch  1 , Petr Bob  1 , Jan Vevera  1   6   7   8
Affiliations

Violence in persons with and without psychosis in the Czech Republic: risk and protective factors

Martin Černý et al. Neuropsychiatr Dis Treat. .

Abstract

Purpose: To prevent violence among persons with psychosis, further knowledge of the correlates and risk factors is needed. These risk factors may vary by nation.

Patients and methods: This study examined factors associated with violent assaults in 158 patients with psychosis and in a matched control sample of 158 adults without psychosis in the Czech Republic. Participants completed interviews and questionnaires to confirm diagnoses, report on aggressive behavior, current and past victimization, and substance use. Additional information was collected from collateral informants and clinical files. Multiple regression analyses were conducted to identify factors that were independently associated with committing an assault in past 6 months.

Results: The presence of a psychotic disorder was associated with an increased risk of assaults (OR =3.80; 95% CI 2.060-7.014). Additional risk factors in persons with and without psychosis included recent physical victimization (OR =7.09; 95% CI 3.922-12.819), childhood maltreatment (OR =3.15; 95% CI 1.877-5.271), the level of drug use (OR =1.13; 95% CI 1.063-1.197), and the level of alcohol use (OR =1.04; 95% CI 1.000-1.084). Increasing age (OR =0.96; 95% CI 0.942-0.978) and employment (OR =0.30; 95% CI 0.166-0.540) were protective factors. Except for drug use, which appeared to have greater effect on violence in the group without psychosis, there were no major differences between patients and controls in these risk and protective factors. To our knowledge, this is the first published comparison of assault predictors between schizophrenia patients and matched controls.

Conclusion: Recent physical victimization was the strongest predictor of assaults. Our findings are consistent with the emerging empirical evidence pointing to the very important role of victimization in eliciting violent behavior by the victims. Some current prediction instruments may underestimate the risk of violent behavior as they take little account of current victimization. Although psychosis per se elevates the risk of violence, other risk and protective factors for violence in persons with psychosis and comparison group are largely similar.

Keywords: psychosis; risk; schizophrenia; victimization; violence.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

References

    1. Hodgins S, Alderton J, Cree A, Aboud A, Mak T. Aggressive behaviour, victimization and crime among severely mentally ill patients requiring hospitalisation. Br J Psychiatry. 2007;191:343–350. - PubMed
    1. Fazel S, Långström N, Hjern A, Grann M, Lichtenstein P, Schizophrenia LP. Schizophrenia, substance abuse, and violent crime. JAMA. 2009;301(19):2016–2023. - PMC - PubMed
    1. Witt K, van Dorn R, Fazel S. Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PLoS One. 2013;8(2):e55942. - PMC - PubMed
    1. Fazel S, Chang Z, Fanshawe T, et al. Prediction of violent reoffending on release from prison: derivation and external validation of a scalable tool. Lancet Psychiatry. 2016;3(6):535–543. - PMC - PubMed
    1. Hodgins S. Violent behaviour among people with schizophrenia: a framework for investigations of causes, and effective treatment, and prevention. Philos Trans R Soc Lond B Biol Sci. 2008;363(1503):2505–2518. - PMC - PubMed