統合失調症,薬物乱用,暴力犯罪などがあります
Seena Fazel1, Niklas Långström, Anders Hjern
1Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, England. seena.fazel@psych.ox.ac.uk
JAMA
|May 21, 2009
まとめ
統合失調症の個人は,特に薬物乱用がある場合,暴力犯罪のリスクが高い. この研究は,薬物乱用が,この増加したリスクの多くを媒介することを示唆しています.
科学分野:
- 法医学精神医学は,法医学精神医学である.
- 臨床心理学の臨床心理学について
- 公衆衛生は公衆衛生である.
背景:
- 統合失調症の診断は,一般の人々と比較して,暴力犯罪のリスクが4~6倍に増加するとの関連があります.
- 統合失調症患者のための普遍的な暴力リスク評価を推奨する現在のガイドラインにもかかわらず,この高いリスクのメディエーターに関して重大な不確実性が存在します.
研究 の 目的:
- 統合失調症と診断された患者の暴力犯罪のリスクを定量化するために.
- 統合失調症と暴力犯罪との関連における媒介者としての薬物乱用の役割を調査する.
主な方法:
- 縦断的な研究では,スウェーデン全国の登録 (1973年−2006年) を利用し,入院と刑事有罪判決を関連付けました.
- 統合失調症患者の暴力犯罪リスクの比較 (n=8003) と一般集団の対照群 (n=80,025) を比較し,混同因子を調整し,薬物乱用併発症の評価を行った.
- 統合失調症患者の影響を受けていない兄弟姉妹のリスクを比較することによって,家族間の混同を調査した.
主要な成果:
- 統合失調症の患者は,暴力犯罪のリスクが2.0倍 (13.2%対5.3%) 増加しました.
- 薬物乱用併発症は,このリスクを大きく増幅した (リスクは4.4倍),薬物乱用のない統合失調症患者ではリスクはわずかに増加した (1.2倍).
- 薬物乱用患者のリスクの増加は,薬物乱用患者と影響を受けていない兄弟姉妹を比較する際に (1.8倍) ほど顕著ではなかったため,家族的な混同 (遺伝的または早期の環境) が示唆されました.
結論:
- 統合失調症は暴力犯罪のリスクの増加と関連しており,薬物乱用が重要な仲介者として作用しています.
- この結果は,統合失調症および併発性薬物乱用患者のリスク評価,管理および治療戦略のさらなる検討の必要性を強調しています.
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