Torrey E F
National Institute of Mental Health Neuroscience Center at St. Elizabeths Hospital, Washington, DC 20032.
Hosp Community Psychiatry. 1994 Jul;45(7):653-62. doi: 10.1176/ps.45.7.653.
The perceived association between violent behavior and serious mental illness was explored to determine the validity of claims by mental health advocates that individuals with serious mental illness are no more dangerous than members of the general population.
The author reviewed recent studies and media accounts of violent behavior by individuals with serious mental illness, with emphasis given to the most recent studies.
Although the vast majority of individuals with serious mental illness are not more dangerous than members of the general population, recent findings suggest the existence of a subgroup that is more dangerous. A history of violent behavior, noncompliance with medications, and substance abuse are important predictors of violent behavior in this subgroup. The findings imply that the criteria for involuntary hospitalization, involuntary medication, outpatient commitment, the monitoring of medication compliance, and other mandated follow-up procedures may need to be revised. The existence of a subgroup of seriously mentally ill patients who exhibit violent behavior undermines efforts by mental health advocates to reduce the stigma of mental illness by denying an association with violence. Until the problem of violence by this subgroup is addressed, it will be difficult to substantially decrease the stigma associated with serious mental illness.
探讨暴力行为与严重精神疾病之间的感知关联，以确定心理健康倡导者所声称的严重精神疾病患者并不比普通人群更具危险性这一说法的有效性。
作者回顾了近期关于严重精神疾病患者暴力行为的研究及媒体报道，重点关注最新研究。
尽管绝大多数严重精神疾病患者并不比普通人群更具危险性，但近期研究结果表明存在一个更具危险性的亚组。暴力行为史、不遵医嘱服药以及药物滥用是该亚组暴力行为的重要预测因素。这些发现意味着非自愿住院、非自愿服药、门诊治疗承诺、药物依从性监测及其他强制随访程序的标准可能需要修订。存在表现出暴力行为的严重精神疾病患者亚组，这削弱了心理健康倡导者通过否认与暴力的关联来减少精神疾病污名化的努力。在解决该亚组的暴力问题之前，将难以大幅减少与严重精神疾病相关的污名。
