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Risk Factors for Violence in Psychosis: Systematic Review and Meta-Regression Analysis of 110 Studies

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  • Katrina Witt
  • Richard van Dorn
  • Seena Fazel

Abstract

Background: Previous reviews on risk and protective factors for violence in psychosis have produced contrasting findings. There is therefore a need to clarify the direction and strength of association of risk and protective factors for violent outcomes in individuals with psychosis. Method: We conducted a systematic review and meta-analysis using 6 electronic databases (CINAHL, EBSCO, EMBASE, Global Health, PsycINFO, PUBMED) and Google Scholar. Studies were identified that reported factors associated with violence in adults diagnosed, using DSM or ICD criteria, with schizophrenia and other psychoses. We considered non-English language studies and dissertations. Risk and protective factors were meta-analysed if reported in three or more primary studies. Meta-regression examined sources of heterogeneity. A novel meta-epidemiological approach was used to group similar risk factors into one of 10 domains. Sub-group analyses were then used to investigate whether risk domains differed for studies reporting severe violence (rather than aggression or hostility) and studies based in inpatient (rather than outpatient) settings. Findings: There were 110 eligible studies reporting on 45,533 individuals, 8,439 (18.5%) of whom were violent. A total of 39,995 (87.8%) were diagnosed with schizophrenia, 209 (0.4%) were diagnosed with bipolar disorder, and 5,329 (11.8%) were diagnosed with other psychoses. Dynamic (or modifiable) risk factors included hostile behaviour, recent drug misuse, non-adherence with psychological therapies (p values

Suggested Citation

  • Katrina Witt & Richard van Dorn & Seena Fazel, 2013. "Risk Factors for Violence in Psychosis: Systematic Review and Meta-Regression Analysis of 110 Studies," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-15, February.
    • Handle: RePEc:plo:pone00:0055942
    DOI: 10.1371/journal.pone.0055942
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    References listed on IDEAS

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    1. Seena Fazel & Gautam Gulati & Louise Linsell & John R Geddes & Martin Grann, 2009. "Schizophrenia and Violence: Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 6(8), pages 1-15, August.
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    1. Georgios Schoretsanitis & Sarah Eisenhardt & Meret E. Ricklin & David S. Srivastava & Sebastian Walther & Aristomenis Exadaktylos, 2018. "Psychiatric Emergencies of Asylum Seekers; Descriptive Analysis and Comparison with Immigrants of Warranted Residence," IJERPH, MDPI, vol. 15(7), pages 1-10, June.
    2. David A. Huber & Steffen Lau & Martina Sonnweber & Moritz P. Günther & Johannes Kirchebner, 2020. "Exploring Similarities and Differences of Non-European Migrants among Forensic Patients with Schizophrenia," IJERPH, MDPI, vol. 17(21), pages 1-15, October.
    3. Bertine de Vries & Gerdina H M Pijnenborg & Elisabeth C D van der Stouwe & Ellen Visser & Steven de Jong & Pharmaco therapy and outcome survey (PHAMOUS)-investigators & Agna A Bartels-Velthuis & Richa, 2019. "“Please tell me what happened”: A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-15, July.
    4. Madeline Graham & Amy Morgan & Elizabeth Paton & Anna Ross, 2023. "Examining the quality of news media reporting of complex mental illness in relation to violent crime in Australia," International Journal of Social Psychiatry, , vol. 69(8), pages 2110-2120, December.

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