Schizophrenia social impact
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Social Impact and Misconceptions
Views held by the public about mental disorders, including schizophrenia, may not coincide with available evidence or with the views held by some mental health professionals.
Treatment
Some psychiatrists believe patients can be discouraged by friends or family members from taking prescribed medication because of the latters' non-biological views of mental disorders.[1] There is scientific difference of opinion about the use of medication in schizophrenia.[2] Consumers' views on treatment and recovery may differ from those of mental health professionals.[3]
Violence
The relationship between violent acts and schizophrenia is a contentious topic. One survey found that 61% of Americans judged individuals with schizophrenia as likely to commit an act of interpersonal violence, while only 17% thought such an act likely to be committed by a person described as "troubled".[4]
Research on violence indicates that the percentage of people with schizophrenia who commit violent acts is several times higher than the percentage of people without any disorder, but lower than is found for disorders such as alcoholism, and the difference is reduced or not found in same-neighbourhood comparisons when related factors are taken into account, notably sociodemographic variables and substance misuse.[5][6][7][8][9] Studies have indicated that 5 to 10% of those charged with murder in Western countries have a schizophrenia spectrum disorder.[10][11][12]
The occurrence of psychosis in schizophrenia has sometimes been linked to a higher risk of violent acts. Findings on the specific role of delusions or hallucinations have been inconsistent, but have focused on delusional jealousy, perception of threat and command hallucinations. It has been proposed that a certain type of individual with schizophrenia may be most likely to offend, characterized by a history of educational difficulties, low IQ, conduct disorder, early-onset substance misuse and offending prior to diagnosis.[10]
A consistent finding is that individuals with a diagnosis of schizophrenia are often the victims of violent crime—at least 14 times more often than they are perpetrators.[13][14] Another consistent finding is a link to substance misuse, particularly alcohol,[15] among the minority who commit violent acts. Violence by or against individuals with schizophrenia typically occurs in the context of complex social interactions within a family setting,[16] and is also an issue in clinical services[17] and in the wider community.[18] Despite its etymology, schizophrenia is not synonymous with dissociative identity disorder, previously known as multiple personality disorder or split personality; in popular culture the two are often confused.
References
- ↑ American Psychiatric Association. Americans Still Cling to Myths About Mental Illness, Survey Finds. Psychiatric News. December 7, 2001 Volume 36 Number 23 Full text
- ↑ Gould, JE. (2006) Ethical Considerations in Medication-Free Research with Schizophrenia Patients: An Expert Interview with William T. Carpenter, Jr., M.D. Medscape Psychiatry & Mental Health 2006:11(2) Full text available
- ↑
- ↑ Pescosolido BA, Monahan J, Link BG, Stueve A, Kikuzawa S (1999). The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems. American Journal of Public Health. Sep;89(9):1339–45. PMID 10474550
- ↑ Walsh E, Buchanan A, Fahy T (2002). Violence and schizophrenia: examining the evidence. British Journal of Psychiatry. 2002 Jun;180:490–5. PMID 12042226
- ↑ Stuart, H (2003). Violence and mental illness: an overview. World Psychiatry. June; 2(2): 121–124. PMID 16946914 Full text, Retrieved on 2007-05-17.
- ↑ Steadman HJ, Mulvey EP, Monahan J, et al (1998). Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry. May;55(5):393–401. PMID 9596041
- ↑ Swanson JW, Swartz MS, Van Dorn RA, Elbogen EB, et al (2006). A national study of violent behavior in persons with schizophrenia. Archives of General Psychiatry. May;63(5):490–9. PMID 16651506
- ↑ Swanson JW, Holzer CE, Ganju VK, Jono RT. (1990) Violence and Psychiatric Disorder in the Community: Evidence From the Epidemiologic Catchment Area Surveys Hosp Community Psychiatry 41:761-770, July 1990 PMID 2142118
- ↑ 10.0 10.1 Mullen PE (2006). Schizophrenia and violence: from correlations to preventive strategies. Advances in Psychiatric Treatment 12: 239–248. Full text available, Retrieved on 2007-05-17.
- ↑ Simpson AI, McKenna B, Moskowitz A, Skipworth J, Barry-Walsh J (2004). Homicide and mental illness in New Zealand, 1970–2000. British Journal of Psychiatry, 185, 394–8. PMID 15516547
- ↑ Fazel S, Grann M (2004). Psychiatric morbidity among homicide offenders: a Swedish population study. American Journal of Psychiatry, 161(11), 2129–31. PMID 15514419
- ↑ Brekke JS, Prindle C, Bae SW, Long JD (2001). Risks for individuals with schizophrenia who are living in the community. Psychiatric Services. Oct;52(10):1358–66. PMID 11585953
- ↑ Fitzgerald PB, de Castella AR, Filia KM, Filia SL, Benitez J, Kulkarni J (2005). Victimization of patients with schizophrenia and related disorders. Australia and New Zealand Journal of Psychiatry, 39(3), 169-74. (1), 187–9. PMID 15701066
- ↑ Walsh E, Gilvarry C, Samele C, et al (2004). Predicting violence in schizophrenia: a prospective study. Schizophrenia Research, 67(2–3), 247-52. PMID 14984884
- ↑ Solomon PL, Cavanaugh MM, Gelles RJ (2005). Family Violence among Adults with Severe Mental Illness. Trauma, Violence, & Abuse, Vol. 6, No. 1, 40–54. PMID 15574672Full text available.
- ↑ Chou KR, Lu RB, Chang M (2001). Assaultive behavior by psychiatric in-patients and its related factors. Journal of Nursing Research. Dec;9(5):139–51. PMID 11779087
- ↑ Logdberg B, Nilsson LL, Levander MT, Levander S (2004). Schizophrenia, neighbourhood, and crime. Acta Psychiatrica Scandinavica, 110(2) Page 92. PMID 15233709 Full text available, Retrieved on 2007-05-16