TABLE 1. Selected Studies Supporting Link Between Mental Illness and Violence

Study Major Findings

Swanson et al. (1990) Major mental disorders creates 5x risk of violence
Link et al. (1992) Patient groups 2–3x more violent than nonpatient groups (when symptomatic); psychotic symptoms predict violence, even in nonpatient groups
Hodgins (1992) Sweden birth cohort study: odds ratio (OR) = 4 for major mental disorder and violence
Link and Stueve (1994) Violence predicted by three specific psychotic symptoms: threat, control, and override
Swanson et al. (1996) Replicates Link and Stueve (1994) using Epidemiological Catchment Area study data
Link et al. (1998) Threat and control/override symptoms independently predict violence
Tiihonen, Isohanni, Rasanen, Kioranen, and Moring (1997) Finland birth cohort: OR = 7 for male schizophrenia and violence
Hoptman et al. (1999) Dual diagnosis of schizophrenia and SA and thought disorder correlated with violence
Swanson et al. (2000) Paranoid and threat/control-override (TCO) symptoms significantly associated with risk of violence
McNeil et al. (2000) Among civil inpatients, command hallucinations created 2.5x increase in violence
Brennan, Mednick, and Hodgins (2000) Denmark birth cohort: OR = 4.6 for male schizophrenia and violence, 23 for female schizophrenia and violence
Arsenault, Moffitt, Caspi, Taylor, and Silva (2000) New Zealand birth cohort: alcohol dependence (OR = 1.9), marijuana dependence (OR = 3.8), and schizophrenia -spectrum disorders (OR = 2.5) each strongly related to violence
Gray et al. (2003) Brief Psychiatric Rating Scale score significantly correlated with inpatient violence
Wallace, Mullen, and Burgess (2004) Australia birth cohort: Schizophrenia OR = 3.6–6.6 for various cohorts over 25-year period
Beck (2004) Delusions present in half of cases of serious violence, most of TCO type; but delusional violence uncommon in absence of SA history
Swanson et al. (2006) Serious violence risk associated with higher positive symptom score and lower negative symptom score (on Positive and Negative Syndrome Scale)
Teasdale et al. (2006) For males, threat delusions increase risk of violence