Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Sichuan, 610041, Chengdu, China.
BMC Psychiatry. 2022 Mar 8;22(1):172. doi: 10.1186/s12888-022-03820-7.
Schizophrenia is one of the most common severe mental disorders associated with an increased risk of violence. The present study compares the demographical, clinical, and criminological characteristics of the patients with schizophrenia who committed different types of violence to relatives, acquaintances, or strangers.
Archives of the violent offenders with schizophrenia referred to forensic psychiatric assessments from January 2015 to December 2019 in the West China Forensic Medicine Assessment Center in China were analyzed. The demographic information, mental illness history, and criminological characteristics of the offenders were collected. The clinical symptoms, previous violent behaviors, and social deficits were also evaluated. One-way ANOVA, Kruskal-Wallis test, Chi-square test, and logistic regression analysis were enrolled to do the statistical analysis.
The study enrolled 332 cases: 165 cases (49.7%) in the acquaintance victim group (AV), 96 cases (28.9%) in the relative victim group (RV), and 71 cases (21.4%) in the stranger victim group (SV). The multinomial logistic regression analysis revealed that older patients were less likely to attack relatives (OR = 0.966, 95% CI = 0.944-0.990; p = 0.005), and strangers, (OR = 0.971, 95% CI = 0.944-0.998; p = 0.034). Patients who lived with others were more inclined to attack relatives (OR = 15.057, 95% CI = 3.508-64.628; p < 0.001). Additionally, employed patients were more likely to attack strangers (OR = 2.034, 95% CI = 1.036-3.994; p = 0.039). The regression equation did not include psychiatric symptoms. For RV and AV victims, the risk of death was higher compared to that of SV victims (OR = 13.778, p < 0.001; OR = 2.663, p = 0.014).
In the interpersonal violence cases committed by schizophrenia patients, the victim type correlates with demographic characteristics of offenders such as living situation, age, and employment status, but not with the psychiatric symptoms. The majority of victims were acquaintances and relatives, and the relative victims having more severe injuries. In order to decrease interpersonal violence, especially violent crimes, more people, especially family members and neighbors, should be educated about symptoms of schizophrenia, the ways to communicate with the patients, and the methods for crisis management.
精神分裂症是一种最常见的严重精神障碍，与暴力风险增加有关。本研究比较了患有精神分裂症的患者对亲属、熟人或陌生人实施不同类型暴力的人口学、临床和犯罪学特征。
分析了 2015 年 1 月至 2019 年 12 月期间在中国华西法医评估中心接受法医精神病评估的有暴力犯罪史的精神分裂症患者的档案。收集了罪犯的人口统计学信息、精神病史和犯罪学特征。还评估了临床症状、以前的暴力行为和社会缺陷。采用单因素方差分析、克鲁斯卡尔-沃利斯检验、卡方检验和逻辑回归分析进行统计分析。
本研究共纳入 332 例患者：熟人受害者组（AV）165 例（49.7%），亲属受害者组（RV）96 例（28.9%），陌生人受害者组（SV）71 例（21.4%）。多变量逻辑回归分析显示，年龄较大的患者不太可能攻击亲属（OR=0.966，95%CI=0.944-0.990；p=0.005），也不太可能攻击陌生人（OR=0.971，95%CI=0.944-0.998；p=0.034）。与他人同住的患者更倾向于攻击亲属（OR=15.057，95%CI=3.508-64.628；p<0.001）。此外，有工作的患者更有可能攻击陌生人（OR=2.034，95%CI=1.036-3.994；p=0.039）。回归方程未包括精神症状。对于 RV 和 AV 受害者，与 SV 受害者相比，死亡风险更高（OR=13.778，p<0.001；OR=2.663，p=0.014）。
在精神分裂症患者的人际暴力案件中，受害者类型与罪犯的人口统计学特征（如生活状况、年龄和就业状况）相关，但与精神症状无关。大多数受害者是熟人或亲属，而亲属受害者的伤势更严重。为了减少人际暴力，特别是暴力犯罪，应更多地对包括亲属和邻居在内的人进行精神分裂症症状、与患者沟通的方式以及危机管理方法的教育。
