Homicide by men diagnosed with schizophrenia: national case-control study
Open Access
- 16 November 2020
- journal article
- research article
- Published by Royal College of Psychiatrists in BJPsych Open
- Vol. 6 (6), e143
- https://doi.org/10.1192/bjo.2020.129
Abstract
Background Some people diagnosed with schizophrenia are more prone to committing acts of serious violence, especially in the presence of drug or alcohol misuse. The rarity of homicide has meant that no large controlled study has previously examined clinical risk factors. Aims To determine the risk factors for homicide by males diagnosed with schizophrenia. Method A national nested case-control study of all previously admitted males diagnosed with schizophrenia, convicted of homicide between 1 January 1997 and 31 December 2012. Univariate and multivariable conditional logistic regression models were fitted to identify predictors of homicide in this population. Results During the observation period 160 male patients with schizophrenia and a history of psychiatric admission were convicted of homicide, and they were matched with 542 male control patients who had not been convicted of homicide. Patients who committed homicide were more likely to have a history of violence and comorbid personality disorder or drug misuse. They were more likely to have missed their last contact with services prior to the offence and to have been non-adherent with their treatment plan. Almost all (94%) of homicides were committed by patients who had a history of alcohol or drug misuse and/or who were not in receipt of planned treatment. Conclusions In England and Wales, homicides by patients with schizophrenia without substance misuse and in receipt of planned care are exceptionally rare. To prevent serious violence, mental health services should focus on drug and alcohol misuse, treatment adherence and maintaining contact with services.This publication has 24 references indexed in Scilit:
- National study comparing the characteristics of patients diagnosed with schizophrenia who committed homicide vs. those who died by suicideThe Journal of Forensic Psychiatry & Psychology, 2018
- Cuts to addiction services are a false economyBMJ, 2017
- Addiction services in England: in need of an interventionThe Lancet Psychiatry, 2014
- Homicide in discharged patients with schizophrenia and other psychoses: A national case-control studySchizophrenia Research, 2010
- Perpetrators of homicide with schizophrenia: sociodemographic characteristics and clinical factors in the eastern region of TurkeyComprehensive Psychiatry, 2010
- Schizophrenia, Substance Abuse, and Violent CrimeJAMA, 2009
- Violent behaviour among people with schizophrenia: a framework for investigations of causes, and effective treatment, and preventionPhilosophical Transactions B, 2008
- Mental Disorders and Violence in a Total Birth CohortArchives of General Psychiatry, 2000
- Mental disorder and clinical care in people convicted of homicide: national clinical surveyBMJ, 1999
- Schizophrenia and Homicidal BehaviorSchizophrenia Bulletin, 1996