Victimization in Schizophrenia and Its Relation to Violence

Abstract

Background: People with schizophrenia are frequently victims of violence. Previous attempts to examine the reasons for this have been limited to cross-sectional studies that fail to distinguish potential causes from consequences of such violence.

Method: We studied patients with schizophrenia participating in the NIMH-funded Clinical Antipsychotic Treatment for Intervention Effectiveness (CATIE) trial. The dependent variable was self-reported victimization during the 18-month follow-up period. Independent variables assessed at study entry included demographics, childhood experiences, recent victimization and violent behavior, social circumstances, and symptoms. Bivariate and multivariate analyses examined correlates of victimization, and among those victimized, correlates of concomitant violent behavior.

Results: Some 206 of 1,179 patients (17.5%) reported experiencing one or more acts of victimization over the 18-months with 54.9% of these also acting violently themselves. Most victimization was by family or acquaintances. Controlling for other variables, victimization was associated with having been recently victimized at baseline as well as with sexual abuse in childhood, spending time with close friends and depressive but not schizophrenia symptoms. Those reporting violent behavior in addition to victimization reported far more violent behavior at baseline and more frequent interactions with close friends.

Conclusions: Victimization in schizophrenia often involves aggressive behavior and is related to greater social involvement, past trauma, substance use and depression more than to schizophrenia symptoms. Treatments that encourage socialization may incur an unintended risk of victimization.

Note:
Funding Information: Funded by the National Institute of Mental Health.

Declaration of Interests: Authors report no competing interests.

Ethics Approval Statement: The study was approved by the Institutional Review Board at each site. Written informed consent obtained from the patients or their legal guardians.

Keywords: Schizophrenia, victimization, violence, depression, sexual abuse