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Substance Abuse and Violent Crime in Patients With Schizophrenia
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To the Editor: The study by Dr Fazel and colleagues1 linked treatment for schizophrenia, conviction for violent offenses, and a history of substance misuse. The authors found that 27.6% of a sample of patients with schizophrenia and a coexisting substance use disorder committed a violent offense, compared with 8.5% of a control group of patients with schizophrenia without a substance use disorder and 5.1% of a general population control group. They concluded that schizophrenia alone has a modest association with violent offending on the basis of the small difference in the rate of conviction for violent offenses between the population control group and the non–substance-using schizophrenia group.
We are concerned that methods used in this study have 2 important limitations that might have led to a significant underestimation of the risk of violent crimes committed by people with schizophrenia. First, the population control group included people with substance use disorders. . . . [Full Text of this Article]
Glen Smith, MBBS
glsmith@nsccahs.health.nsw.gov.au
Northern Sydney Central Coast Area Health Service
Sydney, Australia
Matthew Large, MBBS;
Olav Nielssen, MBBS, MCrim
School of Psychiatry
University of New South Wales
Sydney
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