Violence and delusions: data from the MacArthur Violence Risk Assessment Study
Department of Psychiatry
Adolescent; Adult; Cohort Studies; Delusions; Female; Follow-Up Studies; Humans; Male; Mental Disorders; Patient Discharge; Prospective Studies; Risk Factors; Violence
Life Sciences | Medicine and Health Sciences
OBJECTIVE: Previous work has suggested that delusions are associated with a higher risk of violence, particularly delusions in which patients believe that people are seeking to harm them or that outside forces are controlling their minds (denoted as "threat/control override" delusions). This study explores the relationship between delusions and violence among patients recently discharged from acute psychiatric hospitalization. METHOD: Data were drawn from the MacArthur Violence Risk Assessment Study, a study of violence in the community that followed 1,136 recently discharged psychiatric patients for 1 year. Interviews at discharge and at five 10-week intervals gathered clinical, historical, situational, and dispositional information, including the presence and nature of delusional thoughts. Violence was ascertained from reports of subjects, collateral informants, and official records. RESULTS: Neither delusions in general nor threat/control override delusions in particular were associated with a higher risk of violent behavior. Comparisons with prior studies suggest that reliance on subject self-reports of delusional symptoms may result in mislabeling as delusions other phenomena that can contribute to violence. CONCLUSIONS: Although delusions can precipitate violence in individual cases, these data suggest that they do not increase the overall risk of violence in persons with mental illness in the year after discharge from hospitalization.
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Citation: Am J Psychiatry. 2000 Apr;157(4):566-72.
DOI of Published Version
The American journal of psychiatry
Appelbaum, Paul S.; Robbins, Paula Clark; and Monahan, John, "Violence and delusions: data from the MacArthur Violence Risk Assessment Study" (2000). Open Access Articles. 136.