Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-26T16:45:12.468Z Has data issue: false hasContentIssue false

Schizophrenia, Violence, Clozapine and Risperidone: a Review

Published online by Cambridge University Press:  06 August 2018

Extract

There is no longer much doubt that there is a small but real association between psychosis and violence directed at others, as well as between psychosis and self-directed violence, including suicide. Schizophrenia and the affective psychoses appear to have a similar order of association with suicide (Caldwell & Gottesman, 1990), but schizophrenia is more likely to be associated with serious other-directed violence. The evidence for the effect of schizophrenia comes from three main directions. There are two substantial cross-sectional USA community studies (Swanson et al, 1990; Link et al, 1992), respectively showing a significant quantitative association between schizophrenia and violence. Comparative studies of illness and offending careers (Lindqvist & Allebeck, 1990; Hodgins, 1992; Coid et al, 1993; Taylor, 1993; Wessely et al, 1994), all show different patterns of violent offending by people with schizophrenia compared with those without a psychotic illness, the 1993 studies confirming that the onset of violence is almost invariably after the onset of illness. The third type of evidence is from phenomenology. Taylor (1985) and Link & Stueve (1994) have shown a strong association between delusions and serious violence, the former demonstrating a specific effect of acting on delusions. (For a more extended discussion see Taylor, 1995.)

Type
Research Article
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albanese, M. J., Khantzian, E. J., Murphy, S. L., et al (1994) Decreased substance use in chronically psychotic patients treated with clozapine. American Journal of Psychiatry, 151, 780781.Google ScholarPubMed
Balassa, M., Deisenhammer, E. & Schevrer, H. (1971) Clozapine, ein nicht ketaleptogenes neuroleptikum, in der behandlung von verhaltensstorungen mit erregungszustanden. Wiener Medizinische Wochenschrift, 121, 9092.Google Scholar
Borison, R. L., Diamond, B. L., Sinha, D., et al (1988) Clozapine withdrawal rebound psychosis. Psychopharmacological Bulletin, 24, 260263.Google Scholar
Bowden, P. (1978) Men remanded into custody for medical reports. British Journal of Psychiatry, 133, 320338.Google Scholar
Buckley, P., Thompson, P., Way, L., et al (1994) Substance abuse among patients with treatment resistant schizophrenia: characteristics and implications for clozapine therapy. American Journal of Psychiatry, 151, 385389.Google ScholarPubMed
Buckley, P., Bartell, J., Donerworth, K., et al (1995) Violence and schizophrenia: clozapine as a specific antiaggression agent. Bulletin of the American Academy of Psychiatry and the Law, 23, 607611.Google ScholarPubMed
Caldwell, C. B. & Gottesman, I. I. (1990) Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophrenia Bulletin, 16, 571589.Google Scholar
Chesterman, L. P., Taylor, P. J., Cox, T., et al (1994) Multiple measures of cerebral state in dangerous mentally disordered inpatients. Criminal Behaviour and Mental Health, 4, 228239.CrossRefGoogle Scholar
Chiles, J. A., Davidson, P. & McBride, D. (1994) Effects of clozapine on use of seclusion and restraint at a state hospital. Hospital and Community Psychiatry, 45, 269271.Google Scholar
Christison, G. W., Kirch, D. G. & Wyatt, R. J. (1991) When symptoms persist: choosing among alternative somatic treatment for schizophrenia. Schizophrenia Bulletin, 17, 217245.Google Scholar
Coid, B., Lewis, S. W. & Reveley, A. M. (1993) A twin study of psychosis and criminality. British Journal of Psychiatry, 163, 8792.Google Scholar
Conley, R. R., Schulz, S. C., Baker, R. W., et al (1988) Clozapine efficacy in schizophrenic nonresponders. Psychopharmacological Bulletin, 24, 269274.Google Scholar
Davison, K. & Bagley, C. R. (1969) Schizophrenia-like psychoses associated with organic disorders of the central nervous system: a review of the literature. Current Problems in Neuropsychiatry (ed. Herrington, R. N.). Ashford: Headley Brothers.Google Scholar
Delal, B., Larkin, E. & Taylor, P. J. (1996) A follow up study of the first 50 patients started on clozapine in Rampton Hospital (1990/1992). Presentation Rampton/SHSA Conference and in preparation for publication.Google Scholar
Dell, S. & Robertson, G. (1988) Sentenced to Hospital. Maudsley Monograph Number 32. Oxford: Oxford University Press.Google Scholar
Dietch, J. T. & Jennings, R. K. (1988) Aggressive dyscontrol in patients treated with benzodiazepines. Journal of Clinical Psychiatry, 49, 184188.Google Scholar
Ebrahim, G. M., Gibler, B., Gacono, C. B., et al (1994) Patient response to clozapine in a forensic psychiatric hospital. Hospital and Community Psychiatry, 45, 271273.Google Scholar
Ekblom, B., Eriksson, K. & Lindstrom, L. H. (1984) Supersensitivity psychosis in schizophrenic patients after sudden clozapine withdrawal. Psychopharmacology, 83, 293294.Google Scholar
Eklund, K. (1987) Supersensitivity and clozapine withdrawal. Psychopharmacology, 91, 135.CrossRefGoogle ScholarPubMed
Fraser, K. & Hepple, J. (1993) Prescribing in a special hospital. Journal of Forensic Psychiatry, 3, 311320.Google Scholar
Gerlach, J. & Peacock, L. (1994) Motor and mental side-effects of clozapine. Journal of Clinical Psychiatry, 55 (Suppl), 107109.Google Scholar
Green, A. I., Zalma, A., Berman, I., et al (1994) Clozapine following ECT: a two-step treatment. Journal of Clinical Psychiatry, 55, 388389.Google ScholarPubMed
Gunn, J., Briscoe, O., Carson, D., et al (1993) The law, adult mental disorder, and the psychiatrist in England and Wales. In Forensic Psychiatry: Clinical, Legal and Ethical Issues (eds Gunn, J. & Taylor, P. J.), pp. 21117. Oxford: Butterworth-Heinemann.Google Scholar
Haller, E. & Binder, R. L. (1990) Clozapine and seizures. American Journal of Psychiatry, 147, 10691071.Google ScholarPubMed
Häfner, H. & Böker, W. (1973) Crimes of Violence of Mentally Abnormal Offenders (trans. H. Marshall, 1982). Cambridge: Cambridge University Press.Google Scholar
Hodgins, S. (1992) Mental disorder, intellectual deficiency and crime. Archives of General Psychiatry, 49, 476483.CrossRefGoogle ScholarPubMed
Humphreys, H. S., Johnstone, E. C., MacMillan, J. F., et al (1992) Dangerous behaviour preceding first admission for schizophrenia. British Journal of Psychiatry, 161, 501505.Google Scholar
Johnstone, E. C., Crow, T. J., Johnson, A. L., et al (1986) The Northwick Park study of first episodes of schizophrenia. British Journal of Psychiatry, 148, 115143.Google Scholar
Kando, J. C., Tohen, M., Castillo, P. H. J., et al (1994) Concurrent use of clozapine and valproate in affective and psychotic disorders. Journal of Clinical Psychiatry, 55, 255257.Google ScholarPubMed
Karson, C. N., Weinberger, D. R., Bigelow, L. B., et al (1982) Clonazepam treatment of chronic schizophrenia: negative results in a double-blind, placebo-controlled trial. American Journal of Psychiatry, 139, 16271628.Google Scholar
Landolt, H. (1958) Serial electroencephalographic investigations during psychotic episodes in epileptic patients and during schizophrenia attacks. In Lectures on Epilepsy (ed. Loventz de Haas, A. M.), pp. 91133. Amsterdam: Elsevier.Google Scholar
De Leon, J., Stenilla, J. K., White, A. O., et al (1994) Anticholinergics to treat clozapine withdrawal. Journal of Clinical Psychiatry, 55, 119120.Google Scholar
Lieberman, J. A., Kane, J. M. & Johns, C. A. (1989) Clozapine: guidelines for clinical management. Journal of Clinical Psychiatry, 50, 329338.Google Scholar
Lieberman, J. A., Safferman, A. Z., Pollack, S., et al (1994) Clinical effects of clozapine in chronic schizophrenia: response to treatment and prediction of outcome. American Journal of Psychiatry, 151, 17441752.Google Scholar
Lindqvist, P. & Allebeck, P. (1990) Schizophrenia and crime. A longitudinal follow-up of 644 schizophrenics in Stockholm. British Journal of Psychiatry, 157, 345350.Google Scholar
Lindstrom, L. H. (1988) The effect of long term treatment with clozapine in schizophrenia: a retrospective study in 96 patients treated with clozapine for up to 13 years. Acta Psychiatrica Scandinavica, 77, 524529.Google Scholar
Link, B., Andrews, H. & Cullen, F. T. (1992) The violent and illegal behaviour of mental patients reconsidered. American Sociological Review, 57, 275292.Google Scholar
Link, B. & Stueve, A. (1994) Psychiatric symptoms and the violent/illegal behaviour of mental patients compared to community controls. In Violence and Mental Disorder. Developments in Risk Assessment (eds Monahan, J. & Steadman, H.). Chicago: University of Chicago Press.Google Scholar
Maden, A., Curle, C., Meux, C., et al (1993) The treatment and security needs of patients in special hospitals. Criminal Behaviour and Mental Health, 3, 290306.Google Scholar
Maier, G. J. (1992) The impact of clozapine on 25 forensic patients. Bulletin of the American Academy of Psychiatry and the Law, 20, 297307.Google Scholar
Meltzer, H. Y. (1991) The mechanism of action of novel antipsychotic drugs. Schizophrenia Bulletin, 17, 263287.Google Scholar
Mental Health Act Commission (1993) Guidance on the administration of clozapine and other treatments requiring blood tests under the provisions of Part IV of the Mental Health Act. Practice Note 1. MHAC; Nottingham NG1 6BG.Google Scholar
Miczek, K. A., Weerts, E., Haney, M., et al (1994) Neurobiological mechanisms controlling aggression preclinical developments for pharmacotherapeutic interventions. Neuroscience and Behavioural Reviews, 18, 97110.CrossRefGoogle ScholarPubMed
Perenyi, A., Kuncz, E. & Bagdy, G. (1985) Early relapse after sudden withdrawal or dose reduction of clozapine. Psychopharmacology, 86, 244.Google Scholar
Pope, H. G., Cole, J. O., Choras, P. T., et al (1986) Apparent neuroleptic malignant syndrome with clozapine and lithium. Journal of Nervous and Mental Disease, 174, 493495.Google Scholar
Povlsen, U. J., Norign, U., Fog, R., et al (1985) Tolerability and therapeutic effect of clozapine: a retrospective investigation of 216 patients treated with clozapine for up to twelve years. Acta Psychiatrica Sandinavica, 71, 176185.Google Scholar
Schmauss, M., Wolff, R., Erfurth, A., et al (1989) Tolerability of long term clozapine treatment. Psychopharmacology, 99, S105S108.Google Scholar
Swanson, J. W., Holzer, C. E., Ganju, V. K., et al (1990) Violence and psychiatric disorder in the community: evidence from the Epidemiologic Catchment Area Surveys. Hospital and Community Psychiatry, 41, 761770.Google Scholar
Tardiff, K. & Sweillam, A. (1980) Assault, suicide and mental illness. schizophrenia. Archives of General Psychiatry, 37, 164169.CrossRefGoogle Scholar
Taylor, P. J. (1985) Motives for offending among violent and psychotic men. British Journal of Psychiatry, 147, 491498.Google Scholar
Taylor, P. J. (1993) Schizophrenia and crime: distinctive patterns in association. In Crime and Mental Disorder (ed. Hodgins, S.), pp. 6385. Beverley Hills, CA: Sage.Google Scholar
Taylor, P. J. (1995) Schizophrenia and the risk of violence. In Schizophrenia (eds Hirsch, S. & Weinberger, D.), pp. 163183. Oxford: Blackwell Science.Google Scholar
Taylor, P. J. & Gunn, J. (1984) Violence and psychosis. British Medical Journal, 288, 19451949; 289, 9–12.Google Scholar
Taylor, P. J. & Gunn, J., Browne, F. W. A., et al (1993) Principles of treatment for the mentally disordered offender. In Forensic Psychiatry: Clinical, Legal and Ethical Issues (eds Gunn, J. & Taylor, P. J.), pp. 646690. Oxford: Butterworth Heinemann.Google Scholar
Thompson, C. (1994) The use of high dose antipsychotic medication. British Journal of Psychiatry, 164, 448458.Google Scholar
Virkkunen, M. (1974) A. Observation on violence in schizophrenia; B. on arson committed by schizophrenics. Acta Psychiatrica Scandinavica, 50, 145160.Google Scholar
Wessely, S. C., Castle, D., Douglas, A. J., et al (1994) The criminal careers of incident cases of schizophrenia. Psychological Medicine, 24, 483502.Google Scholar
Wilson, W. H. & Claussen, A. M. (1994) Seizures associated with clozapine treatment in a state hospital. Journal of Clinical Psychiatry, 55, 184188.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases. Geneva: WHO.Google Scholar
World Health Organization (1992) The Tenth Revision of the International Classification of Mental and Behavioural Disorders (ICD–10). Geneva: WHO.Google Scholar
Yovell, Y. & Opler, L. A. (1994) Clozapine reverses cocaine craving in a treatment-resistant mentally ill chemical abuser: a case report and a hypothesis. Journal of Clinical Psychiatry, 55, 591592.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.