精神分裂症,药物滥用和暴力犯罪
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
概括
精神分裂症患者面临更高的暴力犯罪风险,特别是当药物滥用存在时. 这项研究表明,药物滥用中介了这种增加风险的大部分.
科学领域:
- 法医精神病学 法医精神病学
- 临床心理学 临床心理学
- 公共卫生 公共卫生
背景情况:
- 与一般人群相比,精神分裂症的诊断与暴力犯罪的风险增加了4-6倍.
- 关于这种高风险的媒介存在重大不确定性,尽管目前的指导方针建议对精神分裂症患者进行普遍的暴力风险评估.
研究的目的:
- 量化精神分裂症诊断患者暴力犯罪的风险.
- 调查药物滥用作为精神分裂症和暴力犯罪之间关联的调解者的作用.
主要方法:
- 一项纵向研究利用瑞典全国性登记 (1973-2006) 链接住院和刑事定罪.
- 与精神分裂症患者 (n=8003) 与一般人口对照组 (n=80,025) 的暴力犯罪风险进行比较,并对混因素进行调整并评估药物滥用并发症.
- 通过比较精神分裂症患者未受影响的兄弟姐妹的风险来调查家族混.
主要成果:
- 精神分裂症患者的暴力犯罪风险增加了2.0倍 (13.2%对5.3%).
- 药物滥用并发症显著扩大了这种风险 (风险增加了4.4倍),而在没有药物滥用的精神分裂症患者中,风险仅略有增加 (1.2倍).
- 建议家庭混 (遗传或早期环境),因为在将药物滥用患者与未受影响的兄弟姐妹 (1.8倍) 进行比较时,风险增加不那么明显.
结论:
- 精神分裂症与暴力犯罪风险增加有关,药物滥用作为一个重要的调解者.
- 这些发现强调需要进一步研究精神分裂症和并发性物质滥用患者的风险评估,管理和治疗策略.
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