Haller Reinhard
Medizinischen Universität Innsbruck, Universitätsinstitutfür Suchtforschung A-6820 Feldkirch, Maria Ebene 17, Osterreich.
Psychiatr Danub. 2005 Dec;17(3-4):143-53.
From numerous tests it is clearly to be concluded that between severe mental health problems and the act of violence exists a moderate, but reliable association. With this conclusion, neither old fears of "an unpredictable insane person" should be reactivated nor stigmatisation are to be carried out. Particularly since the whole of humans with psychological disturbances does not exhibit an increased act of violence risk in relation to the average population. It is however necessary to identify subgroups with increased tendency for self- and other aggressive behaviour, to describe aggression-aroused and reducing factors and to appreciate the positive influence of the psychiatric therapy and the social rehabilitation. After today's level of knowledge it is to be proceeded from the following risk indicators: Diagnosis of a paranoid disturbance, male sex, correlation with personality disorder and substance abuse, lack of treatment, increasing social disintegration with a longer treatment process and uncertain competence for the support. Extensive psychiatric treatments reduce the risk clearly. The deinstitutionalisation does not have negative influence with secured ambulatory support. The legal accommodation framework, which is discussed on the basis of the Austrian law situation, is an important modifying factor. Relating to the mental health problem there is just a little relation to the aggressive behaviour in comparison to the average population.
从大量测试中可以明确得出结论,严重心理健康问题与暴力行为之间存在适度但可靠的关联。基于这一结论,既不应重新唤起对“不可预测的疯子”的旧有恐惧,也不应进行污名化。特别是因为与普通人群相比,患有心理障碍的所有人并未表现出暴力行为风险增加。然而,有必要识别出自伤和攻击他人行为倾向增加的亚组,描述引发攻击行为和减少攻击行为的因素,并认识到心理治疗和社会康复的积极影响。根据目前的知识水平,应从以下风险指标入手:偏执性障碍诊断、男性、与人格障碍和药物滥用的相关性、缺乏治疗、随着治疗过程延长社会解体加剧以及支持能力不确定。广泛的心理治疗可明显降低风险。在有可靠的门诊支持的情况下,非机构化不会产生负面影响。基于奥地利法律情况讨论的法律收容框架是一个重要的调节因素。与普通人群相比,心理健康问题与攻击行为之间的关联较小。