Psychiatric Research Unit, Roskilde, Denmark.
Clin Psychol Rev. 2011 Jul;31(5):711-26. doi: 10.1016/j.cpr.2011.03.002. Epub 2011 Mar 23.
Studies of birth cohorts show evidence of greater risk of violence among patients with schizophrenia compared to the general population. However, the contribution of schizophrenia to violence is heavily debated and remains unclear. This debate has spurred research whose focus can be associated with one of the following areas: psychotic symptoms, personality disorders (in particular psychopathy), mentalizing abilities, substance abuse and demographic factors. The aim of the current review is to evaluate the predictive role of these risk factors in the occurrence of violence among patients with schizophrenia. We identified two different trajectories for violent behavior in schizophrenia: one pertains to patients with no prior history of violence or criminal behavior and for whom positive symptoms appear to explain violent behavior, and another where personality pathology, including psychopathy, predict violence, regardless of other symptomatology associated with schizophrenia. Furthermore, emergent data suggest that specific mentalizing profiles can be associated with the occurrence of violence in schizophrenia, an issue that warrants further consideration in future research.
出生队列研究表明，与普通人群相比，精神分裂症患者的暴力风险更高。然而，精神分裂症对暴力的影响存在很大争议，目前仍不清楚。这场争论引发了研究，其重点可以与以下领域之一相关：精神病症状、人格障碍（特别是精神病态）、心理化能力、物质滥用和人口统计学因素。目前的综述旨在评估这些危险因素在精神分裂症患者发生暴力行为中的预测作用。我们确定了精神分裂症患者暴力行为的两种不同轨迹：一种涉及没有先前暴力或犯罪行为史的患者，阳性症状似乎可以解释暴力行为；另一种是人格病理学，包括精神病态，预测暴力行为，而与精神分裂症相关的其他症状无关。此外，新出现的数据表明，特定的心理化特征可能与精神分裂症中暴力的发生有关，这是未来研究中值得进一步考虑的问题。
