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Most psychiatric disorders do not increase risk for violence

In a longitudinal study of adolescents from a juvenile detention center, psychiatric disorders were not predictors of future violence, except for substance use disorders.

Katherine S. Elkington, PhD, of Columbia University Medical School, and colleagues assessed violence and psychiatric disorders via self-reports from 1,659 adolescents in the Cook County Juvenile Temporary Detention Center in Chicago. Study participants, aged 13 to 25 years, were interviewed up to four times between 3 and 5 years after detention.

During follow-up, violence rates decreased from 35% to 21% among males and from 20% to 17% among females.

Study participants with psychiatric disorders had significantly higher odds for violence vs. those without psychiatric disorders (adjusted OR = 3; 95% CI, 1.9-4.7; aOR = 4.4; 95% CI, 3-6.3).

Specific psychiatric disorders were contemporaneously associated with subsequent violence, according to researchers, though, major depressive disorder/dysthymia among males was not associated with subsequent violence.

Linda Teplin

Substance use disorder was a predictor of subsequent violence. Males with drug use disorders (aOR = 3.4; 95% CI, 1.4-8.2) and females with marijuana use disorders (aOR = 2; 95% CI, 1.1-3.8) were significantly more likely to engage in subsequent violence 3 years after detention.

“Our findings are relevant to the recent tragic plane crash in the French Alps,” study researcher Linda Teplin, PhD, of Northwestern University Feinberg School of Medicine, said in a press release: “Our findings show that no one could have predicted that the pilot — who apparently suffered from depression — would perpetrate this violent act. It is not merely a suicide, but an act of mass homicide.”

The study findings do indicate associations between violence and some psychiatric disorders, such as substance use disorders, and therefore suggest that some treatments should address higher risk for violence.

“Providing comprehensive treatment to persons with some psychiatric disorders could reduce violence. We must improve how we address multiple problems — including violent behavior — as part of psychiatric treatment,” Elkington said in the release. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.