A novel approach to determining violence risk in schizophrenia: developing a stepped strategy in 13,806 discharged patients.

PloS One
Jay P SinghSeena Fazel

Abstract

Clinical guidelines recommend that violence risk be assessed in schizophrenia. Current approaches are resource-intensive as they employ detailed clinical assessments of dangerousness for most patients. An alternative approach would be to first screen out patients at very low risk of future violence prior to more costly and time-consuming assessments. In order to implement such a stepped strategy, we developed a simple tool to screen out individuals with schizophrenia at very low risk of violent offending. We merged high quality Swedish national registers containing information on psychiatric diagnoses, socio-demographic factors, and violent crime. A cohort of 13,806 individuals with hospital discharge diagnoses of schizophrenia was identified and followed for up to 33 years for violent crime. Cox regression was used to determine risk factors for violent crime and construct the screening tool, the predictive validity of which was measured using four outcome statistics. The instrument was calibrated on 6,903 participants and cross-validated using three independent replication samples of 2,301 participants each. Regression analyses resulted in a tool composed of five items: male sex, previous criminal conviction, young age at asse...Continue Reading

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Citations

Dec 5, 2015·Nordic Journal of Psychiatry·Aytül KarabekiroğluIşil Zabun Korkmaz
Feb 7, 2015·The British Journal of Psychiatry : the Journal of Mental Science·Katrina WittSeena Fazel
Jan 10, 2019·Sexual Abuse : a Journal of Research and Treatment·Leonel C GonçalvesJérôme Endrass
Feb 28, 2019·International Journal of Methods in Psychiatric Research·Kiersten L JohnsonRichard A Van Dorn
Dec 22, 2020·Focus : Journal of Life Long Learning in Psychiatry·Laura J FochtmannSeung-Hee Hong

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