Brennan P A, Mednick S A, Hodgins S
Department of Psychology, Emory University, Atlanta, Georgia 30322, USA.
Arch Gen Psychiatry. 2000 May;57(5):494-500. doi: 10.1001/archpsyc.57.5.494.
This epidemiological investigation was designed to examine the relationships between each of the major mental disorders and criminal violence. Specifically, we assessed whether a significant relationship exists between violence and hospitalization for a major mental disorder, and whether this relationship differs for schizophrenia, affective psychoses, and organic brain syndromes.
Subjects were drawn from a birth cohort of all individuals born between January 1, 1944, and December 31, 1947, in Denmark (N = 358 180). Because of the existence of accurate and complete national registers, data were available on all arrests for violence and all hospitalizations for mental illness that occurred for individuals in this cohort through the age of 44 years.
There was a significant positive relationship between the major mental disorders that led to hospitalization and criminal violence (odds ratios 2.0-8.8 for men and 3.9-23.2 for women). Persons hospitalized for a major mental disorder were responsible for a disproportionate percentage of violence committed by the members of the birth cohort. Men with organic psychoses and both men and women with schizophrenia were significantly more likely to be arrested for criminal violence than were persons who had never been hospitalized, even when controlling for demographic factors, substance abuse, and personality disorders.
Individuals hospitalized for schizophrenia and men hospitalized with organic psychosis have higher rates of arrests for violence than those never hospitalized. This relationship cannot be fully explained by demographic factors or comorbid substance abuse.
本流行病学调查旨在研究各主要精神障碍与刑事暴力之间的关系。具体而言,我们评估了暴力行为与因主要精神障碍住院之间是否存在显著关联,以及这种关系在精神分裂症、情感性精神病和器质性脑综合征中是否有所不同。
研究对象来自丹麦1944年1月1日至1947年12月31日期间出生的所有个体组成的出生队列(N = 358180)。由于存在准确完整的国家登记系统,可获取该队列中个体在44岁之前所有暴力犯罪逮捕记录以及所有精神疾病住院记录。
导致住院的主要精神障碍与刑事暴力之间存在显著正相关(男性的优势比为2.0 - 8.8,女性为3.9 - 23.2)。因主要精神障碍住院的人在出生队列成员所实施的暴力犯罪中所占比例过高。患有器质性精神病的男性以及患有精神分裂症的男性和女性,即使在控制了人口统计学因素、药物滥用和人格障碍后,因刑事暴力被捕的可能性也显著高于从未住院的人。
因精神分裂症住院的个体以及因器质性精神病住院的男性,暴力犯罪被捕率高于从未住院的人。这种关系不能完全由人口统计学因素或合并药物滥用来解释。