Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-25T11:05:41.619Z Has data issue: false hasContentIssue false
  • English
  • Français

Substance misuse and risk of aggression and offending among the severely mentally ill

Published online by Cambridge University Press:  03 January 2018

Helen Scott ,
Sonia Johnson ,
Paulo Menezes ,
Jonathan Bindman ,
Graham Thornicroft ,
Jane Marshall ,
Paul Bebbington  and
Elizabeth Kuipers
Helen Scott*
Affiliation:
Maudsley Continuing Care Study, Institute of Psychiatry, London
Sonia Johnson
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London
Paulo Menezes
Affiliation:
Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
Jonathan Bindman
Affiliation:
Maudsiey Continuing Care Study, Institute of Psychiatry, London
Graham Thornicroft
Affiliation:
Section of Community Psychiatry, Institute of Psychiatry, London
Jane Marshall
Affiliation:
Addiction Research Unit, Institute of Psychiatry, London
Paul Bebbington
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London
Elizabeth Kuipers
Affiliation:
Department of Clinical Psychology, Institute of Psychiatry, London
*
Sonia Johnson, Department of Psychiatry and Behavioural Sciences, University College London Medical School. Wolfson Building, 48 Riding House Street, London W1N 8AA. e-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The aim of this study was to investigate whether ‘dual diagnosis' (substance misuse and severe mental illness) is associated with aggression and offending.

Method

Twenty-seven people meeting the criteria for both psychotic illness and a substance use disorder and 65 people with psychosis only were interviewed. Case notes were also examined and key workers asked to rate substance misuse and aggression.

Results

The severity of aggression and offending among this community treatment sample was low. Individuals with a dual diagnosis were significantly more likely than those with psychosis only to report any history of committing an offence (P=0.001), or recent hostile behaviour (P=0.001). Keyworkers were more likely to report recent aggression among the dually diagnosed (P=0.01). Significant differences persisted when we used logistic regression to control for potentially confounding demographic and clinical variables.

Conclusions

Dual diagnosis may be an important factor in aggression and offending among severely mentally ill individuals in inner-city areas. Accurate risk assessment requires examination of substance use.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 4 , April 1998 , pp. 345 - 350
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angermeyer, M. C. & Matschinger, H. (1995) Violent attacks on public figures by persons suffering from psychiatric disorders: their effect on the social distance towards the mentally ill. European Archives of Psychiatry and Clinical Neurosciences, 245, 159–164.Google Scholar
Bartels, S. J. Drake, R. A. Wallach, M. A. et al (1991) Characteristic hostility in schizophrenic outpatients. Schizophrenia Bulletin, 17, 163–171.Google Scholar
Cold, J. W. (1994) Dangerous patients with mental illness: increased risks warrant new policies, adequate resources, and appropriate legislation. British Medical Journal, 312, 965–966.Google Scholar
Cuffel, B. J. Shumway, M. Chouljian, T. L. et al (1994) A longitudinal study of substance use and community violence in schizophrenia. Journal of Nervous and Mental Disease, 182, 704–708.CrossRefGoogle ScholarPubMed
Drake, R. E. Osher, F. C. & Wallach, M. A. (1989) Alcohol use and abuse in schizophrenia: a prospective community study. Journal of Nervous and Mental Disease, 177, 408–414.Google Scholar
Gunn, J. & Robertson, G. (1978) Drawing a criminal profile. British Journal of Criminology, 16, 156–160.Google Scholar
Johnson, S. (1997) Dual diagnosis of severe mental illness and substance misuse: a case for specialist services? British Journal of Psychiatry, 171, 205–208.CrossRefGoogle ScholarPubMed
Junginger, J. (1996) Psychosis and violence: the case for a content analysis of psychotic experience. Schizophrenia Bulletin, 22, 91–103.CrossRefGoogle ScholarPubMed
Lehman, A. F. Myers, C. P. Thompson, J. W. et al (1993) Implications of mental and substance use disorders. Journal of Nervous and Mental Disease, 181, 365–370.Google Scholar
Levey, S. & Howells, K. (1994) Accounting for the fear of schizophrenia. Journal of Community and Applied Social Psychology, 4, 313–328.Google Scholar
McGuffin, P. Farmer, A. E. & Harvey, I. H. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.CrossRefGoogle ScholarPubMed
Manzuk, P. M. (1996) Violence, crime and mental illness: how strong a link? Archives of General Psychiatry, 53, 481–486.Google Scholar
Menezes, P. Johnson, S. Thornicroft, G. et al (1996) Drug and alcohol problems among individuals with severe mental illness in south London. British Journal of Psychiatry, 168, 612–619.CrossRefGoogle ScholarPubMed
Modestin, J. & Ammann, R. (1996) Mental disorder and criminality: male schizophrenia. Schizophrenia Bulletin, 22, 69–82.Google Scholar
Nestor, P. G. Haycock, J. Doiron, S. et al (1995) Lethal violence and psychosis: a clinical profile. Bulletin of American Academy of Psychiatry and the Law, 23, 331–334.Google ScholarPubMed
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale (BPRS). Psychiatric Reports, 10, 799–812.CrossRefGoogle Scholar
Sayce, L. (1995) Response to violence: a framework for fair treatment. In Psychiatric Patient Violence: Risk and Response (ed. J. Chrichton), pp. 127–150. London: Duckworth.Google Scholar
StataCorp (1995) Stata Statistical Software Release 4.0. College Station, TX: Stata Corporation.Google Scholar
Susser, E. Conover, S. & Siegel, C. (1992) Life Chart Schedule. Geneva: World Health Organization.Google Scholar
Swanson, J. W. Holzer, C. E. Ganu, V. K. et al (1990) Violence and psychiatric disorder in the community: evidence from the Epidemiological Catchment Area surveys. Hospital and Community Psychiatry, 41, 761–770.Google Scholar
Taylor, P. J. & Monahan, J. (1996) Dangerous patients or dangerous diseases? British Medical Journal, 312, 967–969.Google Scholar
Wessely, S. C. Castle, D. Douglas, A. J. et al (1994) The criminal careers of incident cases of schizophrenia. Psychological Medicine, 24, 483–502.Google Scholar
Wing, J. K. Curtis, R. H. & Beevor, A. S. (1996) HoNOS: Health of the Nation Outcome Scales. Report on Research and Development: July 1993–December 1995. London: College Research Unit, Royal College of Psychiatrists.Google Scholar
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
World Health Organization (1994) SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Version 2. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.