Division of Social and Forensic Psychiatry, Karolinska Institutet, Box 4044, 14104, Huddinge, Sweden.
Psychiatr Serv. 2013 Jul 1;64(7):688-93. doi: 10.1176/appi.ps.201200266.
This study was designed to investigate the base rate of violent behavior, the predictive validity of the Classification of Violence Risk (COVR) software, and specific risk factors for violence among nonforensically involved psychiatric patients in Sweden.
On discharge from two psychiatric hospitals in Stockholm, 331 patients were interviewed. Telephone interviews with the patients and supportive others, as well as data from a national criminal register, were used to measure violent behavior 20 weeks after discharge. After the baseline interview, patients were assigned to different risk groups by the COVR software. Predicted risk was compared with the occurrence of actual acts of violence during the follow-up.
Gender differences in base rates of violent behavior among the general psychiatric population were not found during the 20 weeks of follow-up after discharge. Violent behavior was significantly predicted by young age of males and by level of anger, violent thoughts, and victimization of females. The predictive validity of the COVR software was comparable between females (area under the curve [AUC]=.78) and males (AUC=.76).
Violent behavior was uncommon for all patients. Although several risk factors were significantly associated with violence by each gender, the COVR software could predict violence equally well for both genders.
本研究旨在调查暴力行为的基础发生率、分类暴力风险（COVR）软件的预测效度，以及瑞典非司法精神病患者暴力行为的特定风险因素。
在斯德哥尔摩的两家精神病院出院时，对 331 名患者进行了访谈。通过对患者和支持人员进行电话访谈，以及利用国家犯罪登记处的数据，来衡量出院后 20 周的暴力行为。在基线访谈后，COVR 软件将患者分配到不同的风险组。将预测风险与随访期间实际发生的暴力行为进行比较。
在出院后的 20 周随访期间，未发现一般精神病患者群体中男性暴力行为的基础发生率存在性别差异。男性的年轻年龄、愤怒程度、暴力思想和女性的受害程度与暴力行为显著相关。COVR 软件的预测效度在女性（曲线下面积 [AUC]=.78）和男性（AUC=.76）之间相当。
暴力行为在所有患者中都不常见。尽管一些风险因素与两性暴力行为显著相关，但 COVR 软件可以平等地预测两性的暴力行为。
