Homicide by Patients with Schizophrenia: Three Studies Conducted Using a National Consecutive Case Series

Abstract

Associations between schizophrenia and violence are well-documented, but there is little epidemiological evidence concerning homicide perpetration risk in this patient population. Such information can inform risk management and help services to target specific interventions. This study utilised the National Confidential Inquiry into Homicide and Suicide by People with Mental Illness (NCISH) consecutive case series of all convicted homicide perpetrators in England & Wales and incorporated three interrelated studies: (i) nested case-control study of homicide by patients with schizophrenia, which compared male patients with schizophrenia who were convicted of homicide to matched control patients with schizophrenia who had not perpetrated homicide; (ii) case series of male patients who were diagnosed with schizophrenia and convicted of homicide compared to a randomly selected age-matched comparison group of male patients with schizophrenia who died by suicide; (iii) case series of convicted homicide perpetrators classified according to Hodgins’s (2008) typologies of violent offenders with schizophrenia. The findings generated confirm the association between a diagnosis of schizophrenia and homicide and highlight heightened risk in the presence of co-morbid personality disorder, dual diagnosis, non-adherence with medication and disengagement with services.

Date of Award	1 Aug 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Jennifer Shaw (Supervisor) & Roger Webb (Supervisor)