Psychotic Illness Behind Few Violent Acts: Report

Psychotic Illness Behind Few Violent Acts: Report

Sept. 6

— NEW YORK (Reuters Health) - Despite a few well-publicized cases of people with serious mental illness committing violent crimes, patients with psychosis are responsible for little of the violence in society, according to UK researchers.

They say that, overall, recent studies show that people with psychotic illness have a "modest" increase in the odds of violent behavior. But other factors, including drug abuse and poverty, are much stronger contributors to violence.

"Fear and stigma of mentally ill people have been exaggerated by high profile and occasionally sensationalist reporting of rare, albeit tragic, violent acts," Elizabeth Walsh and Thomas Fahy write in the September 7th issue of the British Medical Journal.

Psychosis, like that seen in schizophrenia, involves a break with reality. Patients show disturbed thinking and perception, including hallucinations and delusions. But violence, according to Walsh and Fahy, is not a common feature of psychotic illness.

In their look at studies in the field, the researchers from Guy's, King's and St. Thomas's School of Medicine in London found that less than 10% of serious violence, including homicide, is attributable to psychotic illness.

Instead, they report, far more violence can be linked to substance abuse--alone or in combination with serious psychiatric illness--as well as mental conditions known as personality disorders. These conditions, which include antisocial personality disorder, involve ingrained, inflexible traits and behaviors that interfere with a person's ability to function in day-to-day life.

In addition, Walsh and Fahy found that being male, young and of low social and economic status are far more important factors than psychotic illness in the odds of violent behavior. They note that a recent US study showed that 16% of low-income men between the ages of 18 and 24 had committed violent acts, "which presents a far greater risk than all people with schizophrenia in the sample."

The researchers conclude that "the scientific literature...refutes the stereotyping of all patients with severe mental illness as dangerous."

It is "inappropriate," they argue, for mental health policy or laws to be driven by a "preoccupation with the risk of violence" among people with psychosis.

SOURCE: British Medical Journal 2002;325:507-508.

Source: http://www.abcnews.go.com/wire/Living/reuters20020906_290.html

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