Substance abuse, schizophrenia and risk of violence

A study published this week in the open access journal PLoS Medicine demonstrates that there is an association between schizophrenia and violence, but shows that this association is greatly increased by drug and alcohol abuse. Importantly, the study also finds that the risk of violence from patients with psychoses who also have substance use disorder is no greater than those who have a substance use disorder but who do not have a psychotic illness – in other words, schizophrenia and other psychotic illnesses do not appear to be responsible for any additional risk of violence above the increased risk associated with substance abuse. Potentially this finding has implications for attempts to reduce violence in society, suggesting that strategies aimed at reducing drug and alcohol abuse would be more successful than focusing on mental illness.

Whether or not there is a link between psychotic illnesses and violence has been disputed in the medical literature as well as being a controversial issue with far-reaching social and policy implications. Seena Fazel, of the Department of Psychiatry at the University of Oxford, and colleagues conducted a systematic review of all previous studies examining psychotic illness and the risk of violence to try and resolve their varied conclusions – some of the previous studies concluded that there is no increased risk of violence from patients with schizophrenia, whilst others have reported that there is a marked increase in the risk of violence in individuals with schizophrenia. The opinion emerging in the last couple of decades that there is a modest association between schizophrenia and violence is thought to have influenced policy and legal developments, with the number of patients in secure hospitals increasing in Western countries. Man y mental health charities and clinicians specializing in mental health contest this opinion – arguing that the perception that people with mental illness are more violent is a myth reinforced by the media, contributing to a social stigma around mental illness that damages many people and prevents understanding.

Substance abuse and schizophrenia combined can lead to anger issues.

In their systematic review, the researchers identified 20 studies that compared the risk of violence among people with psychotic illness with those in the general population. Using statistical tools to allow for the differences between the studies, the researchers found that the risk of violent outcomes did increase for individuals with schizophrenia or other psychoses. Men with schizophrenia or other psychoses were typically four to five times as likely to commit a violent act as a man in the general population; for women with schizophrenia or other psychoses there was an eight times greater risk of violence than women in the general population – although the researchers suggest this might be explained by the lower prevalence of alcohol and drug use in the general female population. When analysing the characteristics that differed between the studies, including study location and whether the diagnosis was for schizophrenia or another psychotic disorder, the researchers found that substance abuse was the only factor causing variation between the studies. Substance abuse greatly increased the risk of violence for those with a psychotic illness, but this increased risk of violence was similar to those in the general population with substance abuse but no psychotic illness – suggesting that most of the excess risk of violence in psychotic patients appears to be mediated by the abuse of drugs and alcohol.

The authors acknowledge that further research is needed to clarify the relationship between schizophrenia and other psychoses, substance abuse, medication adherence and violence. However, the authors suggest that their findings could help redress the stigmatization of patients with schizophrenia and other psychoses. They conclude: “As substance use disorders are three to four times more common than the psychoses, public health strategies to reduce violence could focus on the prevention and treatment of substance abuse at an individual, community and societal level.”

source: http://www.eurekalert.org

More Treatment & Detox Articles

Boozing Blunts Ability to Read Faces

Heavy drinking can affect the ability to recognize other people’s facial emotions, a new study has found. Researchers used functional MRI to monitor brain activity in 15 abstinent long-term alcoholics while they looked at images of faces with positive or negative emotional expressions. The brain scans revealed decreased activation in the amygdala and hippocampus, regions….

Children with Fetal Alcohol Syndrome need intervention

Biggest barrier often mother’s guilt over drinking alcohol during pregnancy, says woman with affected son Alone and grieving the deaths of three close friends, Annette Cutknife drank for all nine months of her pregnancy. A college student at the time, she didn’t care what would happen, but the moment her son was born, she knew….

After the cancer treatment

There are many challenges that the patients have to face after the cancer treatment. After the treatment, there are certain chores that the patient needs to follow in order to ensure that everything stays well. Most often, the patients will need to keep regular follow ups with their doctors. Usually these follow up appointments are….

Hunting ways to protect babies when mom drinks

Drinking during pregnancy can seriously harm a baby’s brain, yet thousands of mothers-to-be still do. Now scientists have begun testing whether a prenatal nutrient might offer those babies a little protection, part of a growing quest for ways to reverse the damage. The only help today: intense behavioral or educational therapies once children with fetal….

Setting Goals and Achieving Them in During Drug Treatment

A major portion of the therapy and counseling that is received in drug treatment programs is focused on setting achievable recovery goals and actually working towards achieving those goals. Unfortunately, addiction can make it difficult to achieve goals and likewise, setting unrealistic goals makes achieving the goals virtually impossible which leads to constant feelings of….