Factors associated with violent crime in patients with schizophrenia

The relationship between schizophrenia and violence is heterogeneous and complex. The aim of this study was to explore the characteristics and the potential risk factors for violence crime in patients with schizophrenia. We conducted a retrospective case-control study, with patients with schizophrenia who were forensically suspected to have committed violent crimes at the Judicial Psychiatric Identification Unit of Xiangya Second Hospital of Central South University from January 1, 2013 to December 31, 2016 used as the studied subjects (the violent group) and patients with schizophrenia who had no history of violent crimes used as controls (the non-violent group). There were 308 individuals in the violent group [subdivided into the homicide group (n = 155) and the injury group (n = 153)] and 139 individuals in the non-violent group. A risk model showed that a history of violence (OR = 2.88, 95% CI: 1.79-4.64) and persecutory delusions (OR = 2.57, 95% CI: 1.63-4.06) were associated with an increased risk of violence, whereas treatment during the previous 4 weeks (OR = 0.29, 95% CI: 0.16-0.51) and insight (OR = 0.30, 95% CI: 0.14-0.62) were associated with a decreased risk of violence. This study provided useful clinical information to identify risk factors for violence and develop better strategic programs to manage violence in patients with schizophrenia.