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Substance misuse and risk of aggression and offending among the severely mentally ill

Published online by Cambridge University Press:  03 January 2018

Helen Scott ,
Sonia Johnson ,
Paulo Menezes ,
Jonathan Bindman ,
Graham Thornicroft ,
Jane Marshall ,
Paul Bebbington  and
Elizabeth Kuipers
Helen Scott*
Affiliation:
Maudsley Continuing Care Study, Institute of Psychiatry, London
Sonia Johnson
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London
Paulo Menezes
Affiliation:
Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
Jonathan Bindman
Affiliation:
Maudsiey Continuing Care Study, Institute of Psychiatry, London
Graham Thornicroft
Affiliation:
Section of Community Psychiatry, Institute of Psychiatry, London
Jane Marshall
Affiliation:
Addiction Research Unit, Institute of Psychiatry, London
Paul Bebbington
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College London
Elizabeth Kuipers
Affiliation:
Department of Clinical Psychology, Institute of Psychiatry, London
*
Sonia Johnson, Department of Psychiatry and Behavioural Sciences, University College London Medical School. Wolfson Building, 48 Riding House Street, London W1N 8AA. e-mail: s.johnson@ucl.ac.uk
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Abstract

Background

The aim of this study was to investigate whether ‘dual diagnosis' (substance misuse and severe mental illness) is associated with aggression and offending.

Method

Twenty-seven people meeting the criteria for both psychotic illness and a substance use disorder and 65 people with psychosis only were interviewed. Case notes were also examined and key workers asked to rate substance misuse and aggression.

Results

The severity of aggression and offending among this community treatment sample was low. Individuals with a dual diagnosis were significantly more likely than those with psychosis only to report any history of committing an offence (P=0.001), or recent hostile behaviour (P=0.001). Keyworkers were more likely to report recent aggression among the dually diagnosed (P=0.01). Significant differences persisted when we used logistic regression to control for potentially confounding demographic and clinical variables.

Conclusions

Dual diagnosis may be an important factor in aggression and offending among severely mentally ill individuals in inner-city areas. Accurate risk assessment requires examination of substance use.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 4 , April 1998 , pp. 345 - 350
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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