Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors

Witt, Katrina, Lichtenstein, Paul and Fazel, Seena 2015, Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors, British journal of psychiatry, vol. 206, no. 5, pp. 424-430, doi: 10.1192/bjp.bp.114.144485.

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Title Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors
Author(s) Witt, Katrina
Lichtenstein, Paul
Fazel, Seena
Journal name British journal of psychiatry
Volume number 206
Issue number 5
Start page 424
End page 430
Total pages 7
Publisher Royal College of Psychiatrists
Place of publication London, Eng.
Publication date 2015-05
ISSN 0007-1250
Summary Background : Violence risk assessment in schizophrenia relies heavily on criminal history factors.

Aims : To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia.

Method : A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification.

Results : Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder.

Conclusions : Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance.
Language eng
DOI 10.1192/bjp.bp.114.144485
Field of Research 170104 Forensic Psychology
Socio Economic Objective 970117 Expanding Knowledge in Psychology and Cognitive Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Royal College of Psychiatrists
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080882

Document type: Journal Article
Collection: School of Health and Social Development
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