Saturday, January 15, 2011

Schizophrenics and Violence

When I was writing about paranoid schizophrenia a few days ago I duly reported that researchers insist that schizophrenics are no more violent than anyone else.

I also added my suspicion that these statistics were wrong, in ways that I was not equipped to explain.

This morning in the Wall Street Journal a forensic psychiatrist from Oxford, Dr. Seena Fazel offers an update on the best studies. It turns out that schizophrenics really are more likely to commit violent acts than other individuals. Link here. 

In Dr. Fazel’s words: “We now know that there is an increased risk of violence in individuals suffering from severe mental illness. This conclusion has been confirmed by large-scale historical studies drawing on routinely collected national data in Sweden, Denmark, Australia and Finland. These have consistently found an increased risk of violence in individuals with schizophrenia, bipolar disorder and some forms of severe brain injury.”

And also: “The most recent systematic review on this subject, published in the journal PLoS Medicine in 2009 and involving over 18,000 subjects in 11 countries, found that individuals with schizophrenia were more likely, as compared to the general public, to commit acts of violence, regardless of how violence was measured. This increase was typically two to five times higher in men with schizophrenia and over four-fold higher in women with schizophrenia. As one expert commented, clinicians have to face up to this ‘unpalatable‘ evidence ‘for the sake of our patients.’ A similar review on bipolar disorder and violence from 2010 found similar increases in risk.”

Dr. Fazel adds that the correlation between psychosis and violence may also be caused by other contributing factors, like drug abuse.

Still and all, when supposedly reputable scientists explain to us that schizophrenics are no more likely to commit acts of violence than anyone else, they have either gotten the facts wrong or are consciously dissembling.

I cannot begin to probe why they might do so, but they might be using the false information to support their campaign against the involuntary commitment of the mentally ill.


Anonymous said...

You have to listen close to the fine print: "Schizophrenics who consistently take their medicine are no more likely to become violent than the general population." That's a paraphrase of Katie Couric on Friday.

As you've mentioned a lot, that's a big if.

Jim said...

Stuart, As both the CFO and HR manager of a small company, I recently had a problem with an employee who was bipolar. We had some incidents with her where we sent employees to her house to see if she was OK when she didn't come to work. She had caused some problems creating discord at work. Ever mindful to avoid an ADA lawsuit, I have had to treat her carefully. When I told a psychologist friend of mine about this she told me that I should have called the police instead of sending employees to visit her. She said that cops are better prepared to handle issues like this involving bipolar people. To make matters worse, this employee has a permit to carry and owns a handgun. Some employees have expressed concerns for their safety. Based on everything I have read, I have told employees that bipolar people are no more prone to violent behavior than average. Now I am finding out that I may have been acting on bad information. It would be nice if the mental health professionals were more honest in reporting information about mental illness. Thank you for being one of the honest ones.