Skip to main content Accessibility help

Psychiatric symptoms and risk of victimisation: a population-based study from Southeast London

  • V. Bhavsar (a1) (a2), K. Dean (a3) (a4), S. L. Hatch (a5), J. H. MacCabe (a1) (a2) and M. Hotopf (a2) (a5)...



Although violence is a vital public health problem, no prospective studies have tested for subsequent vulnerability to violence, as a victim or witness, in members of the general population with a range of psychiatric symptoms, or evaluated the importance of higher symptom burden on this vulnerability.


We used successive waves of a household survey of Southeast London, taken 2 years apart, to test if association exists between psychiatric symptoms (symptoms of psychosis, common mental disorders, post-traumatic stress disorder and personality disorder) and later victimisation, in the form of either witnessing violence or being physically victimised, in weighted logistic regression models. Statistical adjustment was made for prior violence exposure, sociodemographic confounders, substance/alcohol use and violence perpetration. Sensitivity analyses were stratified by violence perpetration, sex and history of mental health service use.


After adjustments, psychiatric symptoms were prospectively associated with reporting any subsequent victimisation (odds ratio (OR) 1.88, 95% confidence interval (CI) 1.25–2.83), a two times greater odds of reporting witnessed violence (OR 2.24, 95% CI 1.33–3.76) and reporting physical victimisation (OR 1.76, 95% CI 1.01–3.06). One more symptom endorsed was accompanied by 47% greater odds of subsequent victimisation (OR 1.47, 95% CI 1.16–1.86). In stratified analyses, statistical associations remained evident in non-perpetrators, and among those without a history of using mental health services, and were similar in magnitude in both men and women.


Psychiatric symptoms increase liability to victimisation compared with those without psychiatric symptoms, independently of a prior history of violence exposure and irrespective of whether they themselves are perpetrators of violence. Clinicians should be mindful of the impact of psychiatric symptoms on vulnerability to victimisation, including among those with common psychiatric symptoms and among those who are not considered at risk of perpetrating violence.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Psychiatric symptoms and risk of victimisation: a population-based study from Southeast London
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Psychiatric symptoms and risk of victimisation: a population-based study from Southeast London
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Psychiatric symptoms and risk of victimisation: a population-based study from Southeast London
      Available formats


This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Vishal Bhavsar, E-mail:


Hide All

Joint senior authors



Hide All
Acierno, R, Brady, K, Gray, M, Kilpatrick, DG, Resnick, H and Best, CL (2002) Psychopathology following interpersonal violence: a comparison of risk factors in older and younger adults. Journal of Clinical Geropsychology 8, 1323.
Alonso, J, Codony, M, Kovess, V, Angermeyer, MC, Katz, SJ, Haro, JM, De Girolamo, G, De Graaf, R, Demyttenaere, K and Vilagut, G (2007) Population level of unmet need for mental healthcare in Europe. The British Journal of Psychiatry 190, 299306.
Bebbington, P and Nayani, T (1995) The psychosis screening questionnaire. International Journal of Methods in Psychiatric Research 5, 1119.
Bebbington, P, Meltzer, H, Brugha, T, Farrell, M, Jenkins, R, Ceresa, C and Lewis, G (2000) Unequal access and unmet need: neurotic disorders and the use of primary care services. Psychological Medicine 30, 13591367.
Brekke, JS, Prindle, C, Bae, SW and Long, JD (2001) Risks for individuals with schizophrenia who are living in the community. Psychiatric Services 52, 13581366.
Brennan, IR, Moore, SC and Shepherd, JP (2010) Risk factors for violent victimisation and injury from six years of the British Crime Survey. International Review of Victimology 17, 209229.
Cabassa, LJ, Ezell, JM and Lewis-Fernández, R (2010) Lifestyle interventions for adults with serious mental illness: a systematic literature review. Psychiatric Services 61, 774782.
Choe, JY, Teplin, LA and Abram, KM (2008) Perpetration of violence, violent victimization, and severe mental illness: balancing public health concerns. Psychiatric Services 59, 153164.
Cohen, LE and Felson, M (1979) Social change and crime rate trends: a routine activity approach. American Sociological Review 44, 588608.
Cotter, J, Drake, RJ and Yung, AR (2016) Adulthood revictimization: looking beyond childhood trauma. Acta Psychiatrica Scandinavica 134, 368.
Dansky, BS, Saladin, ME, Brady, KT, Kilpatrick, DG and Resnick, HS (1995) Prevalence of victimization and posttraumatic stress disorder among women with substance use disorders: comparison of telephone and in-person assessment samples. International Journal of the Addictions 30, 10791099.
de Mooij, LD, Kikkert, M, Lommerse, NM, Peen, J, Meijwaard, SC, Theunissen, J, Duurkoop, PW, Goudriaan, AE, Van, HL and Beekman, AT (2015) Victimisation in adults with severe mental illness: prevalence and risk factors. The British Journal of Psychiatry 207, 515522.
Dean, K, Moran, P, Fahy, T, Tyrer, P, Leese, M, Creed, F, Burns, T, Murray, R and Walsh, E (2007) Predictors of violent victimization amongst those with psychosis. Acta Psychiatrica Scandinavica 116, 345353.
Desmarais, SL, Van Dorn, RA, Johnson, KL, Grimm, KJ, Douglas, KS and Swartz, MS (2014) Community violence perpetration and victimization among adults with mental illnesses. American Journal of Public Health 104, 23422349.
Dolan, MC, Castle, D and McGregor, K (2012) Criminally violent victimisation in schizophrenia spectrum disorders: the relationship to symptoms and substance abuse. BMC Public Health 12, 445.
Dorrington, S, Zavos, H, Ball, H, McGuffin, P, Rijsdijk, F, Siribaddana, S, Sumathipala, A and Hotopf, M (2014) Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and comorbidity. The British Journal of Psychiatry 205, 383.
Fitzpatrick, KM and Boldizar, JP (1993) The prevalence and consequences of exposure to violence among African-American youth. Journal of the American Academy of Child & Adolescent Psychiatry 32, 424430.
Fok, M, Hotopf, M, Stewart, R, Hatch, S, Hayes, R and Moran, P (2014) Personality disorder and self-rated health: a population-based cross-sectional survey. Journal of Personality Disorders 28, 319333.
Fortugno, F, Katsakou, C, Bremner, S, Kiejna, A, Kjellin, L, Nawka, P, Raboch, J, Kallert, T and Priebe, S (2013) Symptoms associated with victimization in patients with schizophrenia and related disorders. PLoS ONE [Electronic Resource] 8, e58142.
Frissa, S, Hatch, SL, Gazard, B, Fear, NT and Hotopf, M and team, S. s. (2013). Trauma and current symptoms of PTSD in a South East London community. Social Psychiatry and Psychiatric Epidemiology 48, 11991209.
Glymour, MM, Weuve, J, Berkman, LF, Kawachi, I and Robins, JM (2005) When is baseline adjustment useful in analyses of change? An example with education and cognitive change. American Journal of Epidemiology 162, 267278.
Goodman, LA, Rosenberg, SD, Mueser, KT and Drake, RE (1997) Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophrenia Bulletin 23, 685696.
Goodman, LA, Thompson, KM, Weinfurt, K, Corl, S, Acker, P, Mueser, KT and Rosenberg, SD (1999) Reliability of reports of violent victimization and posttraumatic stress disorder among men and women with serious mental illness. Journal of Traumatic Stress 12, 587599.
Goodman, LA, Salyers, MP, Mueser, KT, Rosenberg, SD, Swartz, M, Essock, SM, Osher, FC, Butterfield, MI and Swanson, J (2001) Recent victimization in women and men with severe mental illness: prevalence and correlates. Journal of Traumatic Stress 14, 615632.
Greenland, S, Daniel, R and Pearce, N (2016) Outcome modelling strategies in epidemiology: traditional methods and basic alternatives. International Journal of Epidemiology 45, 565575.
Hart, C, de Vet, R, Moran, P, Hatch, SL and Dean, K (2012) A UK population-based study of the relationship between mental disorder and victimisation. Social Psychiatry and Psychiatric Epidemiology 47, 15811590.
Hatch, SL, Harvey, SB and Maughan, B (2010) A developmental-contextual approach to understanding mental health and well-being in early adulthood. Social Science & Medicine 70, 261268.
Hatch, SL, Frissa, S, Verdecchia, M, Stewart, R, Fear, NT, Reichenberg, A, Morgan, C, Kankulu, B, Clark, J and Gazard, B (2011) Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study. BMC Public Health 11, 861.
Hatch, S, Gazard, B, Williams, D, Frissa, S, Goodwin, L, Hotopf, M and Team, SS (2016) Discrimination and common mental disorder among migrant and ethnic groups: findings from a South East London Community sample. Social Psychiatry and Psychiatric Epidemiology 51, 689701.
Hedtke, KA, Ruggiero, KJ, Fitzgerald, MM, Zinzow, HM, Saunders, BE, Resnick, HS and Kilpatrick, DG (2008) A longitudinal investigation of interpersonal violence in relation to mental health and substance use. Journal of Consulting and Clinical Psychology 76, 633.
Hiday, VA, Swartz, MS, Swanson, JW, Borum, R and Wagner, HR (1999) Criminal victimization of persons with severe mental illness. Psychiatric Services 50, 6268.
Hodgins, S, Lincoln, T and Mak, T (2009) Experiences of victimisation and depression are associated with community functioning among men with schizophrenia. Social Psychiatry and Psychiatric Epidemiology 44, 448457.
Honings, S, Drukker, M, ten Have, M, de Graaf, R, van Dorsselaer, S and van Os, J (2017) The interplay of psychosis and victimisation across the life course: a prospective study in the general population. Social Psychiatry and Psychiatric Epidemiology 52, 13631374.
Honkonen, T, Henriksson, M, Koivisto, A-M, Stengard, E and Salokangas, RK (2004) Violent victimization in schizophrenia. Social Psychiatry and Psychiatric Epidemiology 39, 606612.
Howard, L, Trevillion, K, Khalifeh, H, Woodall, A, Agnew-Davies, R and Feder, G (2010) Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychological Medicine 40, 881893.
Johnson, KL, Desmarais, SL, Dorn, RAV and Grimm, KJ (2015) A typology of community violence perpetration and victimization among adults with mental illnesses. Journal of Interpersonal Violence 30, 522540.
Johnson, KL, Desmarais, SL, Tueller, SJ, Grimm, KJ, Swartz, MS and Van Dorn, RA (2016) A longitudinal analysis of the overlap between violence and victimization among adults with mental illnesses. Psychiatry Research 246, 203210.
Kadra, G, Dean, K, Hotopf, M and Hatch, SL (2014) Investigating exposure to violence and mental health in a diverse urban community sample: data from the South East London Community Health (SELCoH) survey. PLoS ONE 9, e93660.
Kamperman, AM, Henrichs, J, Bogaerts, S, Lesaffre, EM, Wierdsma, AI, Ghauharali, RR, Swildens, W, Nijssen, Y, van der Gaag, M, Theunissen, JR, Delespaul, PA, van Weeghel, J, van Busschbach, JT, Kroon, H, Teplin, LA, van de Mheen, D and Mulder, CL (2014) Criminal victimisation in people with severe mental illness: a multi-site prevalence and incidence survey in the Netherlands. PLoS ONE [Electronic Resource] 9, e91029.
Kershaw, C, Nicholas, S and Walker, A (2008) Crime in England and Wales 2007/08: findings from the British Crime Survey and police recorded crime. Home Office Statistical Bulletin 7, 4445.
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M and Nelson, CB (1995) Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry 52, 10481060.
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB and Breslau, N (1999) Epidemiological risk factors for trauma and PTSD. In (Rachel Yehuda, ed.) Risk Factors for Posttraumatic Stress Disorder. Arlington, VA, USA: American Psychiatric Association, pp. 2359.
Khalifeh, H, Johnson, S, Howard, LM, Borschmann, R, Osborn, D, Dean, K, Hart, C, Hogg, J and Moran, P (2015) Violent and non-violent crime against adults with severe mental illness. British Journal of Psychiatry 206, 275282.
Krieger, N (2012) Methods for the scientific study of discrimination and health: an ecosocial approach. American Journal of Public Health 102, 936944.
Krug, EG, Mercy, JA, Dahlberg, LL and Zwi, AB (2002) The world report on violence and health. The Lancet 360, 10831088.
Lehman, AF and Linn, LS (1984) Crimes against discharged mental patients. American Journal of Psychiatry 141, 271274.
Lewis, G and Pelosi, A (1990). Manual of the Revised Clinical Interview Schedule (CIS-R). London: Institute of Psychiatry.
Link, BG, Phelan, JC, Bresnahan, M, Stueve, A and Pescosolido, BA (1999) Public conceptions of mental illness: labels, causes, dangerousness, and social distance. American Journal of Public Health 89, 13281333.
Liu, H, Petukhova, MV, Sampson, NA, Aguilar-Gaxiola, S, Alonso, J, Andrade, LH, Bromet, EJ, De Girolamo, G, Haro, JM, Hinkov, H, Kawakami, N, Koenen, KC, Kovess-Masfety, V, Lee, S, Medina-Mora, ME, Navarro-Mateu, F, O'Neill, S, Piazza, M, Posada-Villa, J, Scott, KM, Shahly, V, Stein, DJ, Ten Have, M, Torres, Y, Gureje, O, Zaslavsky, AM, Kessler, RC, Al-Hamzawi, A, Al-Kaisy, MS, Benjet, C, Borges, G, Bruffaerts, R, Bunting, B, De Almeida, JMC, Cardoso, G, Chatterji, S, Cia, AH, Degenhardt, L, De Jonge, P, Demyttenaere, K, Fayyad, J, Florescu, S, He, Y, Hu, CY, Huang, Y, Karam, AN, Karam, EG, Kiejna, A, Lepine, JP, Levinson, D, McGrath, J, Moskalewicz, J, Pennell, BE, Slade, T, Stagnaro, JC, Viana, MC, Whiteford, H, Williams, DR and Wojtyniak, B (2017) Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys. JAMA Psychiatry 74, 270281.
Maniglio, R (2009) Severe mental illness and criminal victimization: a systematic review. Acta Psychiatrica Scandinavica 119, 180191.
Manthorpe, J and Martineau, S (2010) Serious case reviews in adult safeguarding in England: an analysis of a sample of reports. British Journal of Social Work 41, 224241.
McDonald, CC and Richmond, TR (2008) The relationship between community violence exposure and mental health symptoms in urban adolescents. Journal of Psychiatric and Mental Health Nursing 15, 833849.
Meijwaard, SC, Kikkert, M, De Mooij, LD, Lommerse, NM, Peen, J, Schoevers, RA, Van, R, De Wildt, W, Bockting, CL and Dekker, JJ (2015). Risk of criminal victimisation in outpatients with common mental health disorders. PLoS ONE 10, e0128508.
Miethe, TD, Stafford, MC and Long, JS (1987) Social differentiation in criminal victimization: a test of routine activities/lifestyle theories. American Sociological Review 184194.
Moran, P, Leese, M, Lee, T, Thornicroft, G and Mann, A (2003) Standardised Assessment of Personality – Abbreviated Scale (SAPAS): preliminary validation of a brief screen for personality disorder. The British Journal of Psychiatry 183, 228232.
Morgan, C, Reininghaus, U, Reichenberg, A, Frissa, S, Hotopf, M and Hatch, SL (2014) Adversity, cannabis use and psychotic experiences: evidence of cumulative and synergistic effects. The British Journal of Psychiatry 204, 346353.
Neria, Y, Bromet, EJ, Carlson, GA and Naz, B (2005) Assaultive trauma and illness course in psychotic bipolar disorder: findings from the Suffolk county mental health project. Acta Psychiatrica Scandinavica 111, 380383.
Pearce, N and Richiardi, L (2014) Commentary: three worlds collide: Berkson's bias, selection bias and collider bias. International Journal of Epidemiology 43, 521524.
Pridemore, WA and Berg, MT (2017) What is past is prologue: a population-based case-control study of repeat victimization, premature mortality, and homicide. Aggressive Behavior 43, 176189.
Prins, A, Ouimette, P, Kimerling, R, Camerond, RP, Hugelshofer, DS, Shaw-Hegwer, J, Thrailkill, A, Gusman, FD and Sheikh, JI (2003) The primary care PTSD screen (PC PTSD): development and operating characteristics. Primary Care Psychiatry 9, 914.
Resnick, HS, Acierno, R and Kilpatrick, DG (1997) Health impact of interpersonal violence. 2: medical and mental health outcomes. Behavioral Medicine 23, 6578.
Rodway, C, Flynn, S, While, D, Rahman, MS, Kapur, N, Appleby, L and Shaw, J (2014) Patients with mental illness as victims of homicide: a national consecutive case series. The Lancet Psychiatry 1, 129134.
Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR and Grant, M (1993) Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction 88, 791804.
Schneider, AL (1981) Methodological problems in victim surveys and their implications for research in victimology. The Journal of Criminal Law and Criminology (1973-) 72, 818838.
Schomerus, G, Heider, D, Angermeyer, MC, Bebbington, PE, Azorin, JM, Brugha, T and Toumi, M (2008) Urban residence, victimhood and the appraisal of personal safety in people with schizophrenia: results from the European Schizophrenia Cohort (EuroSC). Psychological Medicine 38, 591597.
Silver, E, Arseneault, L, Langley, J, Caspi, A and Moffitt, TE (2005) Mental disorder and violent victimization in a total birth cohort. American Journal of Public Health 95, 20152021.
StataCorp (2014) Stata Statistical Software: Release 14. Special Edition.
Stickley, A and Carlson, P (2010) Factors associated with non-lethal violent victimization in Sweden in 2004-2007. Scandinavian Journal of Public Health 38, 404410.
Sturup, J, Sorman, K, Lindqvist, P and Kristiansson, M (2011) Violent victimisation of psychiatric patients: a Swedish case–control study. Social Psychiatry and Psychiatric Epidemiology 46, 2934.
Szatkowski, L and McNeill, A (2014) Diverging trends in smoking behaviors according to mental health Status. Nicotine & Tobacco Research 17, 356360.
Tsigebrhan, R, Shibre, T, Medhin, G, Fekadu, A and Hanlon, C (2014) Violence and violent victimization in people with severe mental illness in a rural low-income country setting: a comparative cross-sectional community study. Schizophrenia Research 152, 275282.
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, Van Os, J and Bentall, RP (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661671.
Walby, S, Towers, J, Balderston, S, Corradi, C, Francis, B, Heiskanen, M, Helweg-Larsen, K, Mergaert, L, Olive, P and Palmer, E (2017). The Concept and Measurement of Violence Against Women and Men. London: Policy Press.
Walsh, E, Moran, P, Scott, C, McKenzie, K, Burns, T, Creed, F, Tyrer, P, Murray, RM and Fahy, T (2003) Prevalence of violent victimisation in severe mental illness. British Journal of Psychiatry 183, 233238.
Wohlfarth, T, Winkel, FW, Ybema, JF and van den Brink, W (2001) The relationship between socio-economic inequality and criminal victimisation: a prospective study. Social Psychiatry and Psychiatric Epidemiology 36, 361370.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed