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Prevalence and correlates of criminal victimization in Taiwanese outpatients with severe mental illness: a
Chien-Chi Hsu1,2,3, Chun-Kai Fang1,3,4,5,6, Ying Lin1
1Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
Background:
Individuals with severe mental illness (SMI), including schizophrenia and bipolar disorder, are at increased risk of criminal victimization. However, evidence from Asian populations remains limited. This study examined the prevalence of criminal victimization and its associated sociodemographic and clinical factors among Taiwanese adults with SMI.
Methods:
In this cross-sectional study, 798 adults with schizophrenia (39.8%) or bipolar disorder (60.2%) who had received outpatient psychiatric care for at least one year at a medical center in northern Taiwan were recruited. Data on past-year criminal victimization, sociodemographic characteristics, and clinical variables were collected. Depressive symptoms, demoralization, medication adherence, and personal and social functioning were assessed using the Patient Health Questionnaire-9 (PHQ-9), Demoralization Scale, Medication Adherence Rating Scale, and Personal and Social Performance Scale, respectively. Univariate analyses and multivariable logistic regression were performed to identify factors associated with criminal victimization.
Results:
Overall, 25.1% of participants (n = 200) reported experiencing criminal victimization during the previous year. Living with family members (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.37-0.85, p = 0.004) and a diagnosis of bipolar disorder rather than schizophrenia (OR = 0.66, 95% CI = 0.45-0.98, p = 0.035) were associated with lower odds of victimization. Higher odds were associated with a history of suicide attempts (OR = 1.93, 95% CI = 1.35-2.75, p = 0.001), smoking (OR = 1.69, 95% CI = 1.18-2.43, p = 0.004), criminal history (OR = 1.70, 95% CI = 1.06-2.73, p = 0.029), prior psychiatric hospitalization (OR = 1.58, 95% CI = 1.15-2.18, p = 0.015), and greater depressive symptom severity (OR per one-point increase on the PHQ-9 = 1.05, 95% CI = 1.03-1.08, p < 0.001).
Conclusion:
Criminal victimization was common among Taiwanese adults with SMI, affecting one in four participants. Victimization was associated with several potentially modifiable clinical factors, particularly depressive symptoms, prior suicide attempts, and psychiatric hospitalization, while family cohabitation appeared to be protective. These findings highlight the importance of incorporating victimization risk assessment into routine psychiatric care and developing preventive interventions that strengthen family support and address modifiable clinical vulnerabilities.
