Substance Abuse and Violent Crime in Patients With Schizophrenia—Reply
- Seena Fazel, MD seena.fazel@psych.ox.ac.ukDepartment of PsychiatryUniversity of OxfordOxford, United England;
- Niklas Långström, MD, PhD;
- Paul Lichtenstein, PhDDepartment of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholm, Sweden
Since this article does not have an abstract, we have provided the first 150 words of the full text.
In Reply: Dr Smith and colleagues raise concerns that our longitudinal analyses may have underestimated the risk of violent crime in schizophrenia. Specifically, they suggest that the rate of violent crime in patients without comorbid substance abuse should be compared with individuals in the general population who are not substance abusers. We believe that this is a different question. Because substance abuse is highly prevalent1 and possibly treatable in schizophrenia,2 our approach has potentially important implications for psychiatric services and public health.
Nevertheless, when analyzing the data as suggested by Smith et al, the adjusted odds ratio is 1.6 (95% confidence interval, 1.4-1.8) for patients with schizophrenia who are not substance abusers compared with population controls who are not substance abusers. However, the sensitivity of register-based data on substance abuse diagnoses in the general population is likely to be worse than for schizophrenia since inpatient admissions (which are …
