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.
Fazel S, Långström N, Lichtenstein P. Substance Abuse and Violent Crime in Patients With Schizophrenia—Reply. JAMA. 2009;302(11):1168-1169. doi:10.1001/jama.2009.1332