SEVERE MENTAL ILLNESS ALONE DOES NOT PREDICT VIOLENT CRIME

Contrary to popular perception, individuals with schizophrenia, bipolar disorder, or major depression alone are no more likely than others to commit violent crimes, a new study reveals. Future violence, such as fighting, sexual assault, or arson, was statistically more likely among individuals with severe mental illness only in the presence of comorbid substance abuse and/or dependence, according to data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

"Factors such as young age, male sex, parental criminal history, recent divorce, and recent unemployment were stronger predictors of future violence than mental illness," study author Eric B. Elbogen, PhD, from the University of North Carolina at Chapel Hill, told Medscape Psychiatry.

However, having 3 combined factors — severe mental illness, substance abuse or dependence, and a history of violence — was linked with a nearly 10-fold greater risk of future violence than having mental illness alone. "Clinicians could use this [finding] as a red flag to detect patients who should undergo a more formal violence risk assessment," said Dr. Elbogen. The study is published in the February issue of the Archives of General Psychiatry.

"The data shows it is simplistic as well as inaccurate to say the cause of violence among mentally ill individuals is the mental illness itself," the authors write. "Instead, the current study finds that mental illness is clearly relevant to violence risk but that its causal roles are complex, indirect, and embedded in a web of other (and arguably more) important individual and situational cofactors to consider," they add.

-Adapted from “Severe Mental Illness Alone Does Not Predict Violent Crime” by Marlene Busko, Medscape Medical News 2009, http://www.medscape.com/viewarticle/587839. Original article appeared in Arch Gen Psychiatry. 2009;66:152-161.

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