Golenkov Andrei, Large Matthew, Nielssen Olav, Tsymbalova Alla
Chuvash State University, Cheboksary, Russia.
Prince of Wales Hospital and University of New South Wales, Australia.
BJPsych Open. 2021 Dec 1;8(1):e3. doi: 10.1192/bjo.2021.1048.
The extent to which rates of homicide by people with or without schizophrenia vary over time has theoretical and practical implications in understanding homicide by people with mental illness.
The aim was to report on the rates of homicide by people diagnosed with schizophrenia over time in a region in which there were dramatic changes in the overall rates of homicide.
An examination of homicide by people diagnosed with schizophrenia in the course of judicial psychiatric examination, and the rate of other homicide in the Chuvash Republic of the Russian Federation between 1981 and 2020 was undertaken.
During the 40 years of the study a total of 5741 people faced legal proceedings for a homicide offence, of whom 179 (3.1%) were diagnosed with schizophrenia. During the study period the average annual total homicide rate rose from about 9 per 100 000 in the 1980s, peaked at 17 per 100 000 in the 1990s before falling to 13 per 100 000 in the 2000s and 6 per 100 000 in the 2010s. Rates of homicide by people with schizophrenia also rose and fell over this period and were significantly associated with the rates of other homicide (r = 0.503, d.f. = 38, P = 0.001).
The rise and fall in rates of homicide by people diagnosed with schizophrenia in parallel to total homicide suggests that homicidal behaviour might not be intrinsic to the clinical manifestations of the illness, and might instead reflect a heightened vulnerability to social factors that are associated with homicide by people without schizophrenia.
精神分裂症患者与非精神分裂症患者的杀人率随时间变化的程度，对于理解精神疾病患者的杀人行为具有理论和实际意义。
本研究旨在报告某地区精神分裂症患者的杀人率随时间的变化情况，该地区的总体杀人率发生了显著变化。
对俄罗斯联邦楚瓦什共和国1981年至2020年期间司法精神病检查中被诊断为精神分裂症患者的杀人情况以及其他杀人率进行了调查。
在40年的研究期间，共有5741人因杀人罪面临法律诉讼，其中179人（3.1%）被诊断为精神分裂症。在研究期间，年平均总杀人率从20世纪80年代的每10万人约9起上升，在90年代达到每10万人17起的峰值，然后在21世纪初降至每10万人13起，在2010年代降至每10万人6起。精神分裂症患者的杀人率在这一时期也有升有降，且与其他杀人率显著相关（r = 0.503，自由度 = 38，P = 0.001）。
被诊断为精神分裂症患者的杀人率与总杀人率同步上升和下降，这表明杀人行为可能并非该疾病临床表现所固有的，相反，可能反映出对与非精神分裂症患者杀人相关的社会因素的易感性增加。
