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Understanding violence in the context of psychosis: contribution of phenomenology and its limitations

Published online by Cambridge University Press:  25 September 2024

Howard Ryland Open the ORCID record for Howard Ryland [Opens in a new window]
Howard Ryland*
Affiliation:
A consultant forensic psychiatrist with the Oxford Health NHS Foundation Trust, UK. Alongside his clinical work in prisons, he is an honorary senior clinical research fellow in the Department of Psychiatry, University of Oxford, UK, a researcher with the National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre, UK, and a junior research fellow at Corpus Christi College, University of Oxford, UK. During his DPhil (completed in 2021), he developed a new outcome measure for forensic mental health services called the FORensic oUtcome Measure (FORUM).
*
Correspondence Dr Howard Ryland. Email: howard.ryland@psych.ox.ac.uk
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Summary

Navigating the complex relationship between violence and psychosis can frequently be challenging. Psychiatrists may find assessing and managing the risk of violence in this context daunting. In their article on the topic, Anderson et al helpfully summarise the role that psychopathology can play in this process. However, although careful elucidation of an individual's experiences may assist in the nuanced formulation of their risk and could offer a specific focus for interventions, the approach has potential shortcomings in certain settings. For some phenomena the link with violence is unclear and it may be constellations of symptoms that are important. Causal pathways are not always linear and there may be important mediators linking psychopathological features to behavioural outcomes. In the resource-limited settings in which many contemporary health services operate, a detailed assessment of psychopathology may be hampered by time or other constraints. Alternative, more scalable solutions may therefore be needed in particular scenarios.

Keywords

Forensic psychiatryphenomenologypsychopathologyrisk assessmentviolence
Type
Commentary
Information
BJPsych Advances , Volume 31 , Issue 1 , January 2025 , pp. 36 - 38
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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Footnotes

Commentary on… The clinical assessment of violence in the context of psychosis. See this issue.

References

Anderson, C, Nathan, R (2024) The clinical assessment of violence in the context of psychosis: taking a phenomenological stance. BJPsych Advances, 30: this issue. Available from: https://doi.org/10.1192/bja.2024.2.Google Scholar
Buchanan, A, Sint, K, Swanson, J, et al (2019) Correlates of future violence in people being treated for schizophrenia. American Journal of Psychiatry, 176: 694–701.CrossRefGoogle ScholarPubMed
Coid, JW, Ullrich, S, Kallis, C, et al (2013) The relationship between delusions and violence: findings from the East London first episode psychosis study. JAMA Psychiatry, 70: 465–71.CrossRefGoogle ScholarPubMed
DeAngelis, T (2022) Mental illness and violence: debunking myths, addressing realities. Monitor on Psychology, 52: 31–6.Google Scholar
Fazel, S, Zetterqvist, J, Larsson, H, et al (2014) Antipsychotics, mood stabilisers, and risk of violent crime. Lancet, 384: 1206–14.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Sunkel, C, Larrauri, CA, et al (2023) Violence and schizophrenia: the role of social determinants of health and the need for early intervention. World Psychiatry, 22: 230–1.CrossRefGoogle ScholarPubMed
Molero, Y, Kaddoura, S, Kuja-Halkola, R, et al (2023) Associations between β-blockers and psychiatric and behavioural outcomes: a population-based cohort study of 1.4 million individuals in Sweden. PLoS Medicine, 20: e1004164.CrossRefGoogle ScholarPubMed
Ogonah, MGT, Seyedsalehi, A, Whiting, D, et al (2023) Violence risk assessment instruments in forensic psychiatric populations: a systematic review and meta-analysis. Lancet Psychiatry, 10: 780–9.CrossRefGoogle ScholarPubMed
Richard, Y, Tazi, N, Frydecka, D, et al (2023) A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology, 42: 17174–86.CrossRefGoogle Scholar
Senior, M, Fazel, S, Tsiachristas, A (2020) The economic impact of violence perpetration in severe mental illness: a retrospective, prevalence-based analysis in England and Wales. Lancet Public Health, 5: e99–106.CrossRefGoogle ScholarPubMed
Whiting, D, Gulati, G, Geddes, JR, et al (2024) Violence in schizophrenia: triangulating the evidence on perpetration risk. World Psychiatry, 23: 158–60.CrossRefGoogle ScholarPubMed
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