Teplin Linda A, McClelland Gary M, Abram Karen M, Weiner Dana A
Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 710 N. Lake Shore Drive, Chicago, IL 60611, USA.
Arch Gen Psychiatry. 2005 Aug;62(8):911-21. doi: 10.1001/archpsyc.62.8.911.
Since deinstitutionalization, most persons with severe mental illness (SMI) now live in the community, where they are at great risk for crime victimization.
To determine the prevalence and incidence of crime victimization among persons with SMI by sex, race/ethnicity, and age, and to compare rates with general population data (the National Crime Victimization Survey), controlling for income and demographic differences between the samples.
Epidemiologic study of persons in treatment. Independent master's-level clinical research interviewers administered the National Crime Victimization Survey to randomly selected patients sampled from 16 randomly selected mental health agencies.
Sixteen agencies providing outpatient, day, and residential treatment to persons with SMI in Chicago, Ill.
Randomly selected, stratified sample of 936 patients aged 18 or older (483 men, 453 women) who were African American (n = 329), non-Hispanic white (n = 321), Hispanic (n = 270), or other race/ethnicity (n = 22). The comparison group comprised 32 449 participants in the National Crime Victimization Survey.
National Crime Victimization Survey, developed by the Bureau of Justice Statistics.
More than one quarter of persons with SMI had been victims of a violent crime in the past year, a rate more than 11 times higher than the general population rates even after controlling for demographic differences between the 2 samples (P<.001). The annual incidence of violent crime in the SMI sample (168.2 incidents per 1000 persons) is more than 4 times higher than the general population rates (39.9 incidents per 1000 persons) (P<.001). Depending on the type of violent crime (rape/sexual assault, robbery, assault, and their subcategories), prevalence was 6 to 23 times greater among persons with SMI than among the general population.
Crime victimization is a major public health problem among persons with SMI who are treated in the community. We recommend directions for future research, propose modifications in public policy, and suggest how the mental health system can respond to reduce victimization and its consequences.
自去机构化以来，大多数严重精神疾病患者现在生活在社区中，他们遭受犯罪侵害的风险很大。
按性别、种族/民族和年龄确定严重精神疾病患者中犯罪受害的患病率和发病率，并将这些比率与一般人群数据（全国犯罪受害调查）进行比较，同时控制样本之间的收入和人口差异。
对接受治疗的人员进行流行病学研究。独立的硕士水平临床研究访谈员对从16个随机选择的心理健康机构中随机抽取的患者进行全国犯罪受害调查。
伊利诺伊州芝加哥市为严重精神疾病患者提供门诊、日间和住院治疗的16个机构。
随机抽取的936名18岁及以上患者的分层样本（483名男性，453名女性），他们分别是非裔美国人（n = 329）、非西班牙裔白人（n = 321）、西班牙裔（n = 270）或其他种族/民族（n = 22）。对照组包括全国犯罪受害调查中的32449名参与者。
由美国司法统计局制定的全国犯罪受害调查。
在过去一年中，超过四分之一的严重精神疾病患者曾是暴力犯罪的受害者，即使在控制了两个样本之间的人口差异后，这一比率仍比一般人群高出11倍多（P<.001）。严重精神疾病患者样本中暴力犯罪的年发病率（每1000人中有168.2起事件）比一般人群发病率（每1000人中有39.9起事件）高出4倍多（P<.001）。根据暴力犯罪的类型（强奸/性侵犯、抢劫、袭击及其子类别），严重精神疾病患者中的患病率比一般人群高6至23倍。
在社区接受治疗的严重精神疾病患者中，犯罪受害是一个主要的公共卫生问题。我们建议了未来研究的方向，提出了公共政策的修改建议，并说明了心理健康系统如何做出反应以减少受害情况及其后果。
