Kaggwa Mark Mohan, Davids Arianna, Mohibi Parwiz, Erb Bailea, Bradford John, Chaimowitz Gary Andrew, Olagunju Andrew Toyin
Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th Hamilton, Ontario, L89 3K7, Canada.
Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th Hamilton, L89 3K7, Ontario, Canada.
Inj Epidemiol. 2024 Dec 18;11(1):66. doi: 10.1186/s40621-024-00551-z.
Understanding the nature and circumstances around the use of weapons to perpetrate an offense among individuals with mental illness is crucial for evidence-informed policies and actions. However, little is known about the prevalence and factors associated with weapon use during index offenses among patients in the forensic system. Therefore, the present study was designed to address this gap and determine the prevalence and the patient and victim characteristics associated with weapon use during the index offense in a Canadian province.
This retrospective exploratory study utilized data extracted from the Ontario Review Board reports of 2014/15. Data was analyzed using Stata, and logistic regression was employed to determine the factors associated with weapon use.
Approximately half (48.11%) of the individuals included in this analysis (n = 819) used weapons during their index offense as an instrument of violence. Both patient-related and victim-related factors had a statistically significant association with weapon use during index offenses. Specifically, two patient-related factors (including a history of hospitalization prior to the index offense and diagnosis of personality disorder) were associated with lower odds of weapon use during the index offense. However, only prior hospitalization remained statistically significant after adjusting for victims' factors. Victim-related factors were associated with both lower and higher odds of weapon use during the index offense. The highest odds of weapon use were found if the victim was an extended family member of the patient, followed by sibling, lover/partner/spouse, parent, and then adult acquaintance. The odds of weapon use during the index offense were lower if victims were healthcare workers, law enforcement professionals, and females when compared to adult strangers.
The study highlights the significant role of both patients' and victims' characteristics as important factors associated with weapon use during index offenses among forensic patients. Notably, prior hospitalization emerged as a crucial factor with a reduced likelihood of weapon use. Implicitly, this underscores the importance of risk mitigation strategies.
了解精神病患者使用武器实施犯罪的性质和相关情况，对于基于证据的政策制定和行动至关重要。然而，对于法医系统中患者在初次犯罪时使用武器的患病率及相关因素，我们知之甚少。因此，本研究旨在填补这一空白，确定加拿大一个省份初次犯罪时使用武器的患病率以及与使用武器相关的患者和受害者特征。
这项回顾性探索性研究利用了从2014/15年安大略省复查委员会报告中提取的数据。使用Stata软件进行数据分析，并采用逻辑回归来确定与使用武器相关的因素。
在本分析纳入的个体中（n = 819），约一半（48.11%）在初次犯罪时将武器作为暴力工具使用。患者相关因素和受害者相关因素在初次犯罪时与使用武器均存在统计学上的显著关联。具体而言，两个患者相关因素（包括初次犯罪前的住院史和人格障碍诊断）与初次犯罪时使用武器的较低几率相关。然而，在调整受害者因素后，只有先前的住院情况仍具有统计学显著性。受害者相关因素与初次犯罪时使用武器的较低和较高几率均相关。如果受害者是患者的大家庭成员，武器使用几率最高，其次是兄弟姐妹、恋人/伴侣/配偶、父母，然后是成年熟人。与成年陌生人相比，当受害者是医护人员、执法专业人员和女性时，初次犯罪时使用武器的几率较低。
该研究强调了患者和受害者特征作为法医患者初次犯罪时与使用武器相关的重要因素的重要作用。值得注意的是，先前住院是武器使用可能性降低的关键因素。这隐含地强调了风险缓解策略的重要性。
