Chapter 12 - Violence in schizophrenia: prevalence, correlates, and treatment effectiveness

Summary

Among the possible complications and adverse outcomes of schizophrenia, perhaps none is more troubling and tragic - albeit infrequent - than violence. Aside from causing physical harm to its victims, violent behavior is ruinous to its perpetrators and costly to the public. It precipitates the loss of personal liberty, necessitates expensive interventions, perpetuates stigma, and disrupts continuity of care. This chapter presents three sets of analyses, adapted from published primary reports. It examines baseline data to estimate the prevalence of serious and minor violence, and to identify significant correlates of each. This chapter explains whether there might be a subgroup of patients whose risk of violence is distinct in its etiology, and perhaps unexplained by the acute psychopathology of schizophrenia. The subgroup utilizes the longitudinal CATIE data to examine the impact of treatment on violence, and specifically compares the effectiveness of five medications, in reducing violence.