Flannery Raymond B, Rachlin Stephen, Walker Andrew P
The Massachusetts Department of Mental Health, Boston 02114, USA.
J Forensic Sci. 2002 May;47(3):558-61.
Literature reviews of individual assaultive patients, repetitively violent patients, and restrained assaultive patients document that persons diagnosed with schizophrenia or personality disorder are at the highest risk to become assaultive. While there has been some initial research of possible predictor variables across diagnostic groups, this six-year retrospective study is the first to compare only persons with schizophrenia or personality disorder on basic demographic and the selected clinical variables of history of violence, personal victimization, and substance use disorder. In this study, the variance suggested that persons with schizophrenia and personality disorder were both likely to be assaultive. Assaults by persons with schizophrenia were somewhat proportional to their presence in the population studied. However, personality disordered patients represented a disproportional increase from the population studied. Younger females with a diagnosis of personality disorder and with histories of violence toward others and personal victimization appeared at increased risk to be assaultive and to require restraints. The findings and their implications for safety and clinical care are discussed.
对个别有攻击行为的患者、反复暴力的患者以及被约束的有攻击行为的患者的文献综述表明,被诊断患有精神分裂症或人格障碍的人实施攻击行为的风险最高。虽然已经对不同诊断组中可能的预测变量进行了一些初步研究,但这项为期六年的回顾性研究首次仅比较了患有精神分裂症或人格障碍的人在基本人口统计学以及暴力史、个人受害情况和物质使用障碍等选定临床变量方面的情况。在这项研究中,差异表明患有精神分裂症和人格障碍的人都有可能实施攻击行为。精神分裂症患者的攻击行为与其在所研究人群中的占比有一定比例关系。然而,人格障碍患者在所研究人群中的占比却不成比例地增加。被诊断患有人格障碍且有对他人暴力史和个人受害史的年轻女性实施攻击行为并需要约束的风险似乎更高。本文讨论了这些发现及其对安全和临床护理的意义。