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NAME : Muskan chauhan

Enrollment no: A1506918236

Section : G

(Term paper)

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.

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