Related Experiment Video
Updated: Apr 17, 2026

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Improving risk assessment in schizophrenia: epidemiological investigation of criminal history factors
Katrina Witt1, Paul Lichtenstein1, Seena Fazel1
1Katrina Witt, DPhil, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Paul Lichtenstein, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Seena Fazel, MD, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Background:
Violence risk assessment in schizophrenia relies heavily on criminal history factors.
Aims:
To investigate which criminal history factors are most strongly associated with violent crime in schizophrenia.
Method:
A total of 13 806 individuals (8891 men and 4915 women) with two or more hospital admissions for schizophrenia were followed up for violent convictions. Multivariate hazard ratios for 15 criminal history factors included in different risk assessment tools were calculated. The incremental predictive validity of these factors was estimated using tests of discrimination, calibration and reclassification.
Results:
Over a mean follow-up of 12.0 years, 17.3% of men (n = 1535) and 5.7% of women (n = 281) were convicted of a violent offence. Criminal history factors most strongly associated with subsequent violence for both men and women were a previous conviction for a violent offence; for assault, illegal threats and/or intimidation; and imprisonment. However, only a previous conviction for a violent offence was associated with incremental predictive validity in both genders following adjustment for young age and comorbid substance use disorder.
Conclusions:
Clinical and actuarial approaches to assess violence risk can be improved if included risk factors are tested using multiple measures of performance.
Related Concept Videos
Psychological and Sociocultural Causes of Schizophrenia
Biological Causes of Schizophrenia
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Schizophrenia
Psychosis and Antipsychotic Drugs: Overview
Psychosis: Goals of Pharmacotherapy

