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January 15, 2020

Violent Acts and Being the Target of Violence Among People With Mental Illness—The Data and Their Limits

Author Affiliations
  • 1New York State Psychiatric Institute, Department of Psychiatry, Columbia University, New York
JAMA Psychiatry. 2020;77(4):345-346. doi:10.1001/jamapsychiatry.2019.4266

Evidence has accumulated over the last 40 years indicating increased rates of violent perpetration and being the target of violence among people with mental illness. Landmark data collected in the early 1980s by the Epidemiologic Catchment Area study found a 12-month prevalence of 12% for any type of violence among people with mental disorders, which dropped to 7% if people with comorbid substance abuse (DSM-III) were excluded, compared with 2% in the general population.1 Similar magnitudes of increased risk have been found in subsequent studies2 and meta-analyses,3 although the absolute rates of violence vary, probably because of differences in the populations sampled, outcome measures, and means of ascertainment.4 However, despite the greater risk associated with mental disorders, the proportion of violence accounted for by mental disorder is small, with 1-year attributable risk estimated at 4% in the Epidemiologic Catchment Area analyses.1

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