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Jennifer Wood - One of the best experts on this subject based on the ideXlab platform.
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the philadelphia foot patrol experiment a randomized controlled trial of police patrol effectiveness in Violent Crime hotspots
Criminology, 2011Co-Authors: Jerry H Ratcliffe, Travis Taniguchi, Elizabeth R Groff, Jennifer WoodAbstract:Originating with the Newark foot patrol experiment, research has found police foot patrols improve community perception of the police and reduce fear of Crime, but are generally unable to reduce the incidence of Crime. Previous tests of foot patrol have, however, suffered from statistical and measurement issues and have not fully explored potential dynamics of deterrence within micro-spatial settings. In this paper we report on the efforts of over 200 foot patrol officers during the summer of 2009 in Philadelphia. GIS analysis was the basis for a randomized controlled trial of police effectiveness across 60 Violent Crime hotspots. Results identified a significant reduction in the level of treatment area Violent Crime after 12 weeks. A linear regression model with separate slopes fitted for treatment and control groups clarified the relationship further. Even after accounting for natural regression to the mean, target areas in the top 40% on pre-treatment Violent Crime counts had significantly less Violent Crime during the operational period. Target areas outperformed the control sites by 23 percent, resulting in a total net effect (once displacement was considered) of 53 Violent Crimes prevented. The results suggest that targeted foot patrols in Violent Crime hotspots can significantly reduce Violent Crime levels as long as a threshold level of violence exists initially. The findings contribute to a growing body of evidence on the contribution of hotspots and place-based policing to the reduction of Crime, and especially Violent Crime, a significant public health threat in the United States. We suggest that intensive foot patrol efforts in Violent hotspots may achieve deterrence at a micro-spatial level, primarily by increasing the certainty of disruption, apprehension and arrest. The theoretical and practical implications for violence reduction are discussed.
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the philadelphia foot patrol experiment a randomized controlled trial of police patrol effectiveness in Violent Crime hotspots
Criminology, 2011Co-Authors: Jerry H Ratcliffe, Travis Taniguchi, Elizabeth R Groff, Jennifer WoodAbstract:Originating with the Newark, NJ, foot patrol experiment, research has found police foot patrols improve community perception of the police and reduce fear of Crime, but they are generally unable to reduce the incidence of Crime. Previous tests of foot patrol have, however, suffered from statistical and measurement issues and have not fully explored the potential dynamics of deterrence within microspatial settings. In this article, we report on the efforts of more than 200 foot patrol officers during the summer of 2009 in Philadelphia. Geographic information systems (GIS) analysis was the basis for a randomized controlled trial of police effectiveness across 60 Violent Crime hotspots. The results identified a significant reduction in the level of treatment area Violent Crime after 12 weeks. A linear regression model with separate slopes fitted for treatment and control groups clarified the relationship even more. Even after accounting for natural regression to the mean, target areas in the top 40 percent on pretreatment Violent Crime counts had significantly less Violent Crime during the operational period. Target areas outperformed the control sites by 23 percent, resulting in a total net effect (once displacement was considered) of 53 Violent Crimes prevented. The results suggest that targeted foot patrols in Violent Crime hotspots can significantly reduce Violent Crime levels as long as a threshold level of violence exists initially. The findings contribute to a growing body of evidence on the contribution of hotspots and place-based policing to the reduction of Crime, and especially Violent Crime, which is a significant public health threat in the United States. We suggest that intensive foot patrol efforts in Violent hotspots may achieve deterrence at a microspatial level, primarily by increasing the certainty of disruption, apprehension, and arrest. The theoretical and practical implications for violence reduction are discussed.
Mario Coccia - One of the best experts on this subject based on the ideXlab platform.
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economic inequality can generate unhappiness that leads to Violent Crime in society
International Journal of Happiness and Development, 2018Co-Authors: Mario CocciaAbstract:Many studies in social sciences have suggested different approaches to explain Violent Crime in society, such as the heat hypothesis that more violence is associated to hot weather. However, these approaches provide a partial explanation of this social issue. This study shows that, controlling climate, socio-economic inequality at country level negatively affects human behaviour and leads to high rates of Violent Crime in society. The socio-economic inequality is one of the contributing factors that generates aversive environments, unhappiness and, as a consequence, high rates of intentional homicides in society. Overall, then, these findings here can clarify whenever possible, a vital source of unhappiness in society that may lead to aggressive behaviour and Violent Crime.
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economic inequality can generate unhappiness that leads to Violent Crime in society
Social Science Research Network, 2018Co-Authors: Mario CocciaAbstract:Many studies in social sciences have suggested different approaches to explain the Violent Crime in society, such as the heat hypothesis that more violence is associated to very hot weather. However, these approaches provide a partial explanation of this social issue. This study shows that, controlling the climate, the socioeconomic inequality at country level negatively affects human be-haviour and leads to high rates of Violent Crime in society. The socioeconomic inequality is one of contributing factors that generates aversive environments, unhappiness and, as a consequence, possibly high rates of intentional homicides in society. Overall, then, the paper here can clarify whenever possible, a vital source of the unhappiness in society that may lead to aggressive behaviour and Violent Crime. Finally, this study can support socioeconomic policies directed to reduce these social issues.
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a theory of general causes of Violent Crime homicides income inequality and deficiencies of the heat hypothesis and of the model of clash
Aggression and Violent Behavior, 2017Co-Authors: Mario CocciaAbstract:Abstract This paper has two goals. The first is to show that the heat hypothesis provides a partial explanation of Violent Crime in society. The second is to suggest an alternative hypothesis that intentional homicides can be explained by the level of income inequality, even when controlling thermal climate and other factors. The vast literature in these research fields has suggested several approaches to explain aggression and Violent behavior in society, such as the heat hypothesis and the model of Climate, Aggression, and Self-control in Humans (CLASH). However, there are at least some factors about aggression and Violent behavior that current theories have trouble explaining. This study proposes income inequality, latitude and their interaction as predictors of intentional homicides. Statistical evidence based on country-level analyses (N = 191 countries) reveals that controlling thermal climate and other factors, socioeconomic inequality is positively associated with Violent Crime. In particular, the findings here seem in general to support the hypothesis that differences between countries in intentional homicides (per 100,000 people) can be explained by the level of income inequality alone, and not thermal climate as a second predictor or the interaction of income inequality and thermal climate. These results suggest that income inequality may overpower the role of hot weather and seasonal variation of temperature to explain the level of Violent Crime in human society. A prediction of this theory here is that societies with low socioeconomic inequality, independently of thermal climate, are not likely to produce high levels of intentional homicides and Violent Crime. This finding can be useful for bringing a new perspective to explain and generalize one of the determinants that generates Violent Crime in human society. Some policy implications are suggested to reduce these social issues.
Jerry H Ratcliffe - One of the best experts on this subject based on the ideXlab platform.
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the philadelphia foot patrol experiment a randomized controlled trial of police patrol effectiveness in Violent Crime hotspots
Criminology, 2011Co-Authors: Jerry H Ratcliffe, Travis Taniguchi, Elizabeth R Groff, Jennifer WoodAbstract:Originating with the Newark foot patrol experiment, research has found police foot patrols improve community perception of the police and reduce fear of Crime, but are generally unable to reduce the incidence of Crime. Previous tests of foot patrol have, however, suffered from statistical and measurement issues and have not fully explored potential dynamics of deterrence within micro-spatial settings. In this paper we report on the efforts of over 200 foot patrol officers during the summer of 2009 in Philadelphia. GIS analysis was the basis for a randomized controlled trial of police effectiveness across 60 Violent Crime hotspots. Results identified a significant reduction in the level of treatment area Violent Crime after 12 weeks. A linear regression model with separate slopes fitted for treatment and control groups clarified the relationship further. Even after accounting for natural regression to the mean, target areas in the top 40% on pre-treatment Violent Crime counts had significantly less Violent Crime during the operational period. Target areas outperformed the control sites by 23 percent, resulting in a total net effect (once displacement was considered) of 53 Violent Crimes prevented. The results suggest that targeted foot patrols in Violent Crime hotspots can significantly reduce Violent Crime levels as long as a threshold level of violence exists initially. The findings contribute to a growing body of evidence on the contribution of hotspots and place-based policing to the reduction of Crime, and especially Violent Crime, a significant public health threat in the United States. We suggest that intensive foot patrol efforts in Violent hotspots may achieve deterrence at a micro-spatial level, primarily by increasing the certainty of disruption, apprehension and arrest. The theoretical and practical implications for violence reduction are discussed.
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the philadelphia foot patrol experiment a randomized controlled trial of police patrol effectiveness in Violent Crime hotspots
Criminology, 2011Co-Authors: Jerry H Ratcliffe, Travis Taniguchi, Elizabeth R Groff, Jennifer WoodAbstract:Originating with the Newark, NJ, foot patrol experiment, research has found police foot patrols improve community perception of the police and reduce fear of Crime, but they are generally unable to reduce the incidence of Crime. Previous tests of foot patrol have, however, suffered from statistical and measurement issues and have not fully explored the potential dynamics of deterrence within microspatial settings. In this article, we report on the efforts of more than 200 foot patrol officers during the summer of 2009 in Philadelphia. Geographic information systems (GIS) analysis was the basis for a randomized controlled trial of police effectiveness across 60 Violent Crime hotspots. The results identified a significant reduction in the level of treatment area Violent Crime after 12 weeks. A linear regression model with separate slopes fitted for treatment and control groups clarified the relationship even more. Even after accounting for natural regression to the mean, target areas in the top 40 percent on pretreatment Violent Crime counts had significantly less Violent Crime during the operational period. Target areas outperformed the control sites by 23 percent, resulting in a total net effect (once displacement was considered) of 53 Violent Crimes prevented. The results suggest that targeted foot patrols in Violent Crime hotspots can significantly reduce Violent Crime levels as long as a threshold level of violence exists initially. The findings contribute to a growing body of evidence on the contribution of hotspots and place-based policing to the reduction of Crime, and especially Violent Crime, which is a significant public health threat in the United States. We suggest that intensive foot patrol efforts in Violent hotspots may achieve deterrence at a microspatial level, primarily by increasing the certainty of disruption, apprehension, and arrest. The theoretical and practical implications for violence reduction are discussed.
Niklas Langstrom - One of the best experts on this subject based on the ideXlab platform.
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antipsychotics mood stabilisers and risk of Violent Crime
The Lancet, 2014Co-Authors: Seena Fazel, Johan Zetterqvist, Henrik Larsson, Niklas Langstrom, Paul LichtensteinAbstract:Summary Background Antipsychotics and mood stabilisers are prescribed widely to patients with psychiatric disorders worldwide. Despite clear evidence for their efficacy in relapse prevention and symptom relief, their effect on some adverse outcomes, including the perpetration of Violent Crime, is unclear. We aimed to establish the effect of antipsychotics and mood stabilisers on the rate of Violent Crime committed by patients with psychiatric disorders in Sweden. Methods We used linked Swedish national registers to study 82 647 patients who were prescribed antipsychotics or mood stabilisers, their psychiatric diagnoses, and subsequent criminal convictions in 2006–09. We did within-individual analyses to compare the rate of Violent criminality during the time that patients were prescribed these medications versus the rate for the same patients while they were not receiving the drugs to adjust for all confounders that remained constant within each participant during follow-up. The primary outcome was the occurrence of Violent Crime, according to Sweden's national Crime register. Findings In 2006–09, 40 937 men in Sweden were prescribed antipsychotics or mood stabilisers, of whom 2657 (6·5%) were convicted of a Violent Crime during the study period. In the same period, 41 710 women were prescribed these drugs, of whom 604 (1·4 %) had convictions for Violent Crime. Compared with periods when participants were not on medication, Violent Crime fell by 45% in patients receiving antipsychotics (hazard ratio [HR] 0·55, 95% CI 0·47–0·64) and by 24% in patients prescribed mood stabilisers (0·76, 0·62–0·93). However, we identified potentially important differences by diagnosis—mood stabilisers were associated with a reduced rate of Violent Crime only in patients with bipolar disorder. The rate of violence reduction for antipsychotics remained between 22% and 29% in sensitivity analyses that used different outcomes (any Crime, drug-related Crime, less severe Crime, and Violent arrest), and was stronger in patients who were prescribed higher drug doses than in those prescribed low doses. Notable reductions in Violent Crime were also recorded for depot medication (HR adjusted for concomitant oral medications 0·60, 95% CI 0·39–0·92). Interpretation In addition to relapse prevention and psychiatric symptom relief, the benefits of antipsychotics and mood stabilisers might also include reductions in the rates of Violent Crime. The potential effects of these drugs on violence and Crime should be taken into account when treatment options for patients with psychiatric disorders are being considered. Funding The Wellcome Trust, the Swedish Prison and Probation Service, the Swedish Research Council, and the Swedish Research Council for Health, Working Life and Welfare.
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risk of Violent Crime in individuals with epilepsy and traumatic brain injury a 35 year swedish population study
PLOS Medicine, 2011Co-Authors: Seena Fazel, Paul Lichtenstein, Martin Grann, Niklas LangstromAbstract:BACKGROUND: Epilepsy and traumatic brain injury are common neurological conditions, with general population prevalence estimates around 0.5% and 0.3%, respectively. Although both illnesses are associated with various adverse outcomes, and expert opinion has suggested increased criminality, links with Violent behaviour remain uncertain. METHODS AND FINDINGS: We combined Swedish population registers from 1973 to 2009, and examined associations of epilepsy (n = 22,947) and traumatic brain injury (n = 22,914) with subsequent Violent Crime (defined as convictions for homicide, assault, robbery, arson, any sexual offense, or illegal threats or intimidation). Each case was age and gender matched with ten general population controls, and analysed using conditional logistic regression with adjustment for socio-demographic factors. In addition, we compared cases with unaffected siblings. Among the traumatic brain injury cases, 2,011 individuals (8.8%) committed Violent Crime after diagnosis, which, compared with population controls (n = 229,118), corresponded to a substantially increased risk (adjusted odds ratio [aOR] = 3.3, 95% CI: 3.1-3.5); this risk was attenuated when cases were compared with unaffected siblings (aOR = 2.0, 1.8-2.3). Among individuals with epilepsy, 973 (4.2%) committed a Violent offense after diagnosis, corresponding to a significantly increased odds of Violent Crime compared with 224,006 population controls (aOR = 1.5, 1.4-1.7). However, this association disappeared when individuals with epilepsy were compared with their unaffected siblings (aOR = 1.1, 0.9-1.2). We found heterogeneity in violence risk by age of disease onset, severity, comorbidity with substance abuse, and clinical subgroups. Case ascertainment was restricted to patient registers. CONCLUSIONS: In this longitudinal population-based study, we found that, after adjustment for familial confounding, epilepsy was not associated with increased risk of Violent Crime, questioning expert opinion that has suggested a causal relationship. In contrast, although there was some attenuation in risk estimates after adjustment for familial factors and substance abuse in individuals with traumatic brain injury, we found a significantly increased risk of Violent Crime. The implications of these findings will vary for clinical services, the criminal justice system, and patient charities. Please see later in the article for the Editors' Summary. Language: en
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bipolar disorder and Violent Crime new evidence from population based longitudinal studies and systematic review
Archives of General Psychiatry, 2010Co-Authors: Seena Fazel, Paul Lichtenstein, Martin Grann, Guy M Goodwin, Niklas LangstromAbstract:Context Although bipolar disorder is associated with various adverse health outcomes, the relationship with Violent Crime is uncertain. Objectives To determine the risk of Violent Crime in bipolar disorder and to contextualize the findings with a systematic review. Design Longitudinal investigations using general population and unaffected sibling control individuals. Setting Population-based registers of hospital discharge diagnoses, sociodemographic information, and Violent Crime in Sweden from January 1, 1973, through December 31, 2004. Participants Individuals with 2 or more discharge diagnoses of bipolar disorder (n = 3743), general population controls (n = 37 429), and unaffected full siblings of individuals with bipolar disorder (n = 4059). Main Outcome Measure Violent Crime (actions resulting in convictions for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). Results During follow-up, 314 individuals with bipolar disorder (8.4%) committed Violent Crime compared with 1312 general population controls (3.5%) (adjusted odds ratio, 2.3; 95% confidence interval, 2.0-2.6). The risk was mostly confined to patients with substance abuse comorbidity (adjusted odds ratio, 6.4; 95% confidence interval, 5.1-8.1). The risk increase was minimal in patients without substance abuse comorbidity (adjusted odds ratio, 1.3; 95% confidence interval, 1.0-1.5), which was further attenuated when unaffected full siblings of individuals with bipolar disorder were used as controls (1.1; 0.7-1.6). We found no differences in rates of Violent Crime by clinical subgroups (manic vs depressive or psychotic vs nonpsychotic). The systematic review identified 8 previous studies (n = 6383), with high heterogeneity between studies. Odds ratio for violence risk ranged from 2 to 9. Conclusion Although current guidelines for the management of individuals with bipolar disorder do not recommend routine risk assessment for violence, this assertion may need review in patients with comorbid substance abuse.
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schizophrenia substance abuse and Violent Crime
JAMA, 2009Co-Authors: Seena Fazel, Martin Grann, Niklas Langstrom, Anders Hjern, Paul LichtensteinAbstract:Results In patients with schizophrenia, 1054 (13.2%) had at least 1 Violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of Violent Crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 Violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; P.001 for interaction). The risk increase among those with substance abuse comorbidity was significantly less pronounced when unaffected siblings were used as controls (28.3% of those with schizophrenia had a Violent offense compared with 17.9% of their unaffected siblings; adjusted OR, 1.8; 95% CI, 1.42.4; P.001 for interaction), suggesting significant familial (genetic or early environmental) confounding of the association between schizophrenia and violence. Conclusions Schizophrenia was associated with an increased risk of Violent Crime in this longitudinal study. This association was attenuated by adjustment for substance abuse, suggesting a mediating effect. The role of risk assessment, management, and treatment in individuals with comorbidity needs further examination.
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risk factors for Violent Crime in schizophrenia a national cohort study of 13 806 patients
The Journal of Clinical Psychiatry, 2009Co-Authors: Seena Fazel, Paul Lichtenstein, Martin Grann, Eva Carlstrom, Niklas LangstromAbstract:Objective: To determine risk factors for and prevalence of Violent Crime in patients with schizophrenia, and in particular, to explore the contribution of familial risk factors. Method: We designed ...
Seena Fazel - One of the best experts on this subject based on the ideXlab platform.
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selective serotonin reuptake inhibitors and Violent Crime a cohort study
PLOS Medicine, 2015Co-Authors: Yasmina Molero, Paul Lichtenstein, Johan Zetterqvist, Clara Hellner Gumpert, Seena FazelAbstract:BACKGROUND: Although selective serotonin reuptake inhibitors (SSRIs) are widely prescribed, associations with violence are uncertain. METHODS AND FINDINGS: From Swedish national registers we extracted information on 856,493 individuals who were prescribed SSRIs, and subsequent Violent Crimes during 2006 through 2009. We used stratified Cox regression analyses to compare the rate of Violent Crime while individuals were prescribed these medications with the rate in the same individuals while not receiving medication. Adjustments were made for other psychotropic medications. Information on all medications was extracted from the Swedish Prescribed Drug Register, with complete national data on all dispensed medications. Information on Violent Crime convictions was extracted from the Swedish national Crime register. Using within-individual models, there was an overall association between SSRIs and Violent Crime convictions (hazard ratio [HR] = 1.19, 95% CI 1.08-1.32, p CONCLUSIONS: The association between SSRIs and Violent Crime convictions and Violent Crime arrests varied by age group. The increased risk we found in young people needs validation in other studies. Language: en
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antipsychotics mood stabilisers and risk of Violent Crime
The Lancet, 2014Co-Authors: Seena Fazel, Johan Zetterqvist, Henrik Larsson, Niklas Langstrom, Paul LichtensteinAbstract:Summary Background Antipsychotics and mood stabilisers are prescribed widely to patients with psychiatric disorders worldwide. Despite clear evidence for their efficacy in relapse prevention and symptom relief, their effect on some adverse outcomes, including the perpetration of Violent Crime, is unclear. We aimed to establish the effect of antipsychotics and mood stabilisers on the rate of Violent Crime committed by patients with psychiatric disorders in Sweden. Methods We used linked Swedish national registers to study 82 647 patients who were prescribed antipsychotics or mood stabilisers, their psychiatric diagnoses, and subsequent criminal convictions in 2006–09. We did within-individual analyses to compare the rate of Violent criminality during the time that patients were prescribed these medications versus the rate for the same patients while they were not receiving the drugs to adjust for all confounders that remained constant within each participant during follow-up. The primary outcome was the occurrence of Violent Crime, according to Sweden's national Crime register. Findings In 2006–09, 40 937 men in Sweden were prescribed antipsychotics or mood stabilisers, of whom 2657 (6·5%) were convicted of a Violent Crime during the study period. In the same period, 41 710 women were prescribed these drugs, of whom 604 (1·4 %) had convictions for Violent Crime. Compared with periods when participants were not on medication, Violent Crime fell by 45% in patients receiving antipsychotics (hazard ratio [HR] 0·55, 95% CI 0·47–0·64) and by 24% in patients prescribed mood stabilisers (0·76, 0·62–0·93). However, we identified potentially important differences by diagnosis—mood stabilisers were associated with a reduced rate of Violent Crime only in patients with bipolar disorder. The rate of violence reduction for antipsychotics remained between 22% and 29% in sensitivity analyses that used different outcomes (any Crime, drug-related Crime, less severe Crime, and Violent arrest), and was stronger in patients who were prescribed higher drug doses than in those prescribed low doses. Notable reductions in Violent Crime were also recorded for depot medication (HR adjusted for concomitant oral medications 0·60, 95% CI 0·39–0·92). Interpretation In addition to relapse prevention and psychiatric symptom relief, the benefits of antipsychotics and mood stabilisers might also include reductions in the rates of Violent Crime. The potential effects of these drugs on violence and Crime should be taken into account when treatment options for patients with psychiatric disorders are being considered. Funding The Wellcome Trust, the Swedish Prison and Probation Service, the Swedish Research Council, and the Swedish Research Council for Health, Working Life and Welfare.
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risk of Violent Crime in individuals with epilepsy and traumatic brain injury a 35 year swedish population study
PLOS Medicine, 2011Co-Authors: Seena Fazel, Paul Lichtenstein, Martin Grann, Niklas LangstromAbstract:BACKGROUND: Epilepsy and traumatic brain injury are common neurological conditions, with general population prevalence estimates around 0.5% and 0.3%, respectively. Although both illnesses are associated with various adverse outcomes, and expert opinion has suggested increased criminality, links with Violent behaviour remain uncertain. METHODS AND FINDINGS: We combined Swedish population registers from 1973 to 2009, and examined associations of epilepsy (n = 22,947) and traumatic brain injury (n = 22,914) with subsequent Violent Crime (defined as convictions for homicide, assault, robbery, arson, any sexual offense, or illegal threats or intimidation). Each case was age and gender matched with ten general population controls, and analysed using conditional logistic regression with adjustment for socio-demographic factors. In addition, we compared cases with unaffected siblings. Among the traumatic brain injury cases, 2,011 individuals (8.8%) committed Violent Crime after diagnosis, which, compared with population controls (n = 229,118), corresponded to a substantially increased risk (adjusted odds ratio [aOR] = 3.3, 95% CI: 3.1-3.5); this risk was attenuated when cases were compared with unaffected siblings (aOR = 2.0, 1.8-2.3). Among individuals with epilepsy, 973 (4.2%) committed a Violent offense after diagnosis, corresponding to a significantly increased odds of Violent Crime compared with 224,006 population controls (aOR = 1.5, 1.4-1.7). However, this association disappeared when individuals with epilepsy were compared with their unaffected siblings (aOR = 1.1, 0.9-1.2). We found heterogeneity in violence risk by age of disease onset, severity, comorbidity with substance abuse, and clinical subgroups. Case ascertainment was restricted to patient registers. CONCLUSIONS: In this longitudinal population-based study, we found that, after adjustment for familial confounding, epilepsy was not associated with increased risk of Violent Crime, questioning expert opinion that has suggested a causal relationship. In contrast, although there was some attenuation in risk estimates after adjustment for familial factors and substance abuse in individuals with traumatic brain injury, we found a significantly increased risk of Violent Crime. The implications of these findings will vary for clinical services, the criminal justice system, and patient charities. Please see later in the article for the Editors' Summary. Language: en
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bipolar disorder and Violent Crime new evidence from population based longitudinal studies and systematic review
Archives of General Psychiatry, 2010Co-Authors: Seena Fazel, Paul Lichtenstein, Martin Grann, Guy M Goodwin, Niklas LangstromAbstract:Context Although bipolar disorder is associated with various adverse health outcomes, the relationship with Violent Crime is uncertain. Objectives To determine the risk of Violent Crime in bipolar disorder and to contextualize the findings with a systematic review. Design Longitudinal investigations using general population and unaffected sibling control individuals. Setting Population-based registers of hospital discharge diagnoses, sociodemographic information, and Violent Crime in Sweden from January 1, 1973, through December 31, 2004. Participants Individuals with 2 or more discharge diagnoses of bipolar disorder (n = 3743), general population controls (n = 37 429), and unaffected full siblings of individuals with bipolar disorder (n = 4059). Main Outcome Measure Violent Crime (actions resulting in convictions for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). Results During follow-up, 314 individuals with bipolar disorder (8.4%) committed Violent Crime compared with 1312 general population controls (3.5%) (adjusted odds ratio, 2.3; 95% confidence interval, 2.0-2.6). The risk was mostly confined to patients with substance abuse comorbidity (adjusted odds ratio, 6.4; 95% confidence interval, 5.1-8.1). The risk increase was minimal in patients without substance abuse comorbidity (adjusted odds ratio, 1.3; 95% confidence interval, 1.0-1.5), which was further attenuated when unaffected full siblings of individuals with bipolar disorder were used as controls (1.1; 0.7-1.6). We found no differences in rates of Violent Crime by clinical subgroups (manic vs depressive or psychotic vs nonpsychotic). The systematic review identified 8 previous studies (n = 6383), with high heterogeneity between studies. Odds ratio for violence risk ranged from 2 to 9. Conclusion Although current guidelines for the management of individuals with bipolar disorder do not recommend routine risk assessment for violence, this assertion may need review in patients with comorbid substance abuse.
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schizophrenia substance abuse and Violent Crime
JAMA, 2009Co-Authors: Seena Fazel, Martin Grann, Niklas Langstrom, Anders Hjern, Paul LichtensteinAbstract:Results In patients with schizophrenia, 1054 (13.2%) had at least 1 Violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of Violent Crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 Violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; P.001 for interaction). The risk increase among those with substance abuse comorbidity was significantly less pronounced when unaffected siblings were used as controls (28.3% of those with schizophrenia had a Violent offense compared with 17.9% of their unaffected siblings; adjusted OR, 1.8; 95% CI, 1.42.4; P.001 for interaction), suggesting significant familial (genetic or early environmental) confounding of the association between schizophrenia and violence. Conclusions Schizophrenia was associated with an increased risk of Violent Crime in this longitudinal study. This association was attenuated by adjustment for substance abuse, suggesting a mediating effect. The role of risk assessment, management, and treatment in individuals with comorbidity needs further examination.
