TITLE- Risk factors of violent crimes in schizophrenia
INTRODUCTION
Schizophrenia is a brain disease that affects the normal functioning
of the brain. It force affected affected people to exhibit odd, disorganized behavior as it affects the brain which is the main organ where our thinking, feelings and understanding develops. But the disease like schizophrenia alters these thinking , feelings and understanding that affects their lives making it even worse.
HOW DOES SCHIZOPHRENIA OCCURS:
The onset of schizophrenia usually occurs in adolescence or early
adulthood. It starts (slowly or quickly) with a prodomal phase of increased social withdrawal, apathy and cognitive impairment. This is followed by a psychotic phase in which the individual is severely disabled because of (Low openness Intellectual, unusual beliefs and experiences and experiences, disorganized lack of insight and often distractibility , forgetfulness, impaired reasoning and detachment, social withdrawal, intimacy avoidance, restricted emotion and loss of interest or pleasure). There is often antagonism and emotional distress. The first 6 months of this disturbance is diagnosed a being schizophrenic disorder. If schizophrenic disorder persists longer than 6 months, the condition is re-diagnosed s being schizophrenia, on 2-4 years follow up, between 80.9% to 83% of the individuals are initially diagnosed from schizophrenia. FIVE TYPES OF SCHIZOPHRENIA:-
Paranoid schizophrenia Disorganized schizophrenia Catatonic schizophrenia Undifferentiated schizophrenia Residual schizophrenia REVIEW OF LITERATURE
1. Niklas Langstrom, et.al (2009) - Found that risk of
violent crimes for patients suffering from schizophrenia and the role that substance abuse plays in mediating this major risk, as patients with schizophrenia are more offensive as compared to that of non schizophrenic patients. The risk factors of violent crimes are comparatively higher in schizophrenic patients with substance abuse as compared to patients without substance abuse.
2. Mickey, kongerslev, et.al (2011) The study aims to
determine the role of risk factors creating violence in the behavior of patients with schizophrenia, it was identified two different paths of violent behavior paths in schizophrenia.
3. Jeffrey W. Swanson, et.al (2007) A lot of other
factors are responsible for violence in schizophrenia besides its own. People having a history of childhood abuse are more likely to show violence than those with no abuse. The group in which there are no conduct problems are more likely to suffer from positive symptoms in schizophrenia.
4. Sheilagh Hodgins, et.al (1999) Criminality in later
years and delinquency has been linked up to physical abuse in childhood. This study was done on more than 100 schizophrenic patients in hospital. More than half of the patients suffered from abuse before manifestation of schizophrenia. Women were the major victims of being suffered from a disordered family.
5. Michael Soyka, et.al (2007) In this it was studied
that violence and offensiveness in patients suffering from schizophrenic had been discussed in various studies but criminal behavior is unpredictable. It is found that patients who were convicted for the physical injury were highly violent than other convicted patients also the patients with lack of understanding were also highly violent but the rate of violence was comparatively low in patients suffering from depression and other minor symptoms. From this study the rate of minor serious offences in former patients with schizophrenia can be indicated easily.
6. Annika Nordstrom, et.al (2003) This study draws
the attention towards examining the risk factors of violence among family members and friends, from schizophrenics in relation to victim gender and the level of violence. All violent offenders were identified and as a result it was found that most of the victims of violent criminals were strangers to them but a level of violence was relatively less. Causing harm to family members there were more female schizophrenics as well as the risk to female family victims specially to mothers was also relatively more than other family members. This study concluded that risk to family members and immediate network of becoming victims are comparatively higher.
7. Ahmad abu-akel, et.al (2004) The role of mind and
intellectual understanding abilities in offensive behavior were studied with paranoid schizophrenia. In this study patients were divided into two groups violent and non-violent based on their actions and were examined to find their mentalizing and empathetic abilities and as a result it was concluded that violent patients faced more problem than non- violent patients in completing empathetic task but was good at completing cognitive tasks and also offensiveness gave a impression of being associated with substance abuse, age factor and other components. At last it was concluded that violence is related to nature towards others, good cognitive and empathetic skills.
8. Gunnar Kullgren (2006) A study was carried out to
understand journey of the parents having adult sons suffering from suffering from schizophrenia. Findings were similar throughout the study group and insensitivity amongst the parents caused complex interactions between them. It is important for psychiatric professional to spread required information so as to make parents aware of the nature of person suffering from the particular disease.
9. Rachael S.Fullam (2008) A study was conducted
on hospitalized patients involved in violence to understand the neuropsychological deficits. Results indicated that individual traits were much more responsible as compared to neuropsychological functions.
10.Alexandre Dumias (2011) Study was conducted
using various methods to understand the involvement of SUD and impulsivity on schizophrenia patients. It was discovered that SUD causes significant possibility of serious violence.
11.Wayne E.Johnson (1988) Demographic traits are
found to more indicative towards future violence as compared to clinical symptoms in schizophrenia patient who experience illusions of prominent political figures. Further research is required in this area to come to final conclusions.
12.M. Henriksson (2004) In Finland the violence
among schizophrenic patients was comparitively lower as compared to that of Britain. The major reasons of violence among patients were found to be financial crisis and substance abuse. There is a greater need of professional help and care as there is a threat to them from the rest of the society members.
13.Gunnar Kullgren (2006) Researches has been
conducted about the experiences, needs and burdens over the families of mentally ill offenders. It was found that the family of ill offenders experienced more stress than non-ill offender. Reason being that their family have to deal with both mental health services and judicial systems. There is a need of further research about the needs and burdens over the family of ill offenders with a main focus on the strengths rather than focusing on the exclusive problems oriented perspectives. It is important to involve the family in health and social care of their member to avoid being regarded as second patients.
14. A. Fresan (2007) Patients of exacerbation of
psychotic symptoms have more risk of violent behavior. It is important to determine about the subtypes of hallucinations and delusions that are implicated in the association of schizophrenia and violent behavior. Violent behavior among schizophrenic patients is a heterogeneous phenomenon which can be best explained in the context of specific symptoms that are associated with violence and course of illness. The retrospective assessment of the variables raises methodological questions that are concerned with the reliability of measurement of the impact of psychotic symptoms on violence.
15.J. Bobes (2009) The evidence has shown that
individuals who are suffering with schizophrenia are at increased risk as compared with the general population in terms of violence. Early stages display a pattern of antisocial behavior that emerges among the children in early adolescence before illness , that remains stable across the lifespan. The largest group among violent offenders having schizophrenia does not showcase antisocial behavior before illness. A small group of individuals who show a chronic course of schizophrenia do not show aggressive behavior in one or two decades after illness and then engage in serious violence.
16.S.Fazel(2007) The inconsistency in the current
treatments for violent behavior in schizophrenia is due, to the etiological heterogeneity of that behavior. We should not except that any of the given pharmacological treatment would be equally effective to reduce violent behavior caused by psychosis. Violence for schizophrenics is etiologically heterogeneous. This heterogeneity has therapeutic implications which creates an impact on clinical practice today and should be further explored in future studies.
17.Michael soyka(2011) Most studies are performed in
clinical samples with aggression as measured bon psychopathological scales. Only fewer studies for schizophrenia patients are performed with homicides. The number of candidate genes have been studied, most of them are found relevant for dopaminergic and serotonergic, neurotransmission. More recently, neuro-imaging studies have explored about interrelationship between violence and brain function. Several findings seem to indicate that in schizophrenia patients with aggression and persistent violence, certain brain functions or areas (in particular the prefrontal and frontal cortex) can be more severely impaired as compared to those schizophrenia patients without aggression or violence. However, additional studies (particularly functional imaging studies) are necessary to further evaluate this question.
18.H.Nicolini (2006) This study confirms the recent
findings for the increased risk about criminal convictions in those, who are suffering with schizophrenia. The risk seems small in terms of attributability. Contributions made by those who are suffering with schizophrenia to the level of recorded crime in the community is slender. Low risk doesn't mean having no risk, thus all the findings must be considered seriously. Further , minor offendings by those who are suffering with schizophenia ,even when detected frequently does not lead to convictions.
19.S.Wessely (1998) The criminal behavior manifested
in patients suffering with schizophrenia, shows certain features especially at motivational level, emphasizes the need for the detection of delusionl and hallucinatory symptoms at early level which forces the patients to indulge in criminal acts in close relationship, social and cultural activities and in context to family, that creates their background.
20. Henry T.Chuang (1987) Criminal behavior
seems to be a common phenomenon among the patient suffering with schizophrenia. These findings about the risk factors of criminal behavior must be taken into consideration when planning for mental health interventions . CONCLUSION Schizophrenia is a psychotic disorder described in a DSM. People suffering from this disorder live in a world of delusions and hallucinations and they have no believe in reality. This disorder has many symptoms. Schizophrenics suffer major disturbance in their daily routine, patients involved with substance abuse are mainly affected, they are more violent as compared to patients with non-substance abuse. From all the researches it is clear that female patients are more violent than males. Patients suffering from this disorder are threat for others as well as for themselves, they generally encounters crimes and the people who are close to them whether family members, close friends and others are usually the victims of patients.