To the Editor The Original Investigation by Sariaslan and colleagues1 is important in questioning previous misperceptions of violence by individuals with serious mental illness and that it is primarily due to comorbid substance misuse.2 However, case registers do not have perfect coverage of all mental disorders in a population, and complex cases with co-occurring disorders may be disproportionately registered—those most likely to experience violence and be perpetrators. There is then the problem of temporal proximity.3
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Coid JW. Limitations of Case Register Studies for Violence and Psychiatric Disorders. JAMA Psychiatry. 2020;77(8):875. doi:10.1001/jamapsychiatry.2020.0830
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