Mental Illness Doesn't Predict Violent Behavior - Even when combined with substance abuse, psychiatric woes rank low as risk factor, study finds

Mental illness alone is not a predictor of future violent behavior, but mental illness combined with substance abuse or dependence does increase the risk, according to U.S. researchers who analyzed data collected from nearly 35,000 people.

People who have a severe mental illness but no substance abuse or a history of violence weren't any more likely than any other person in the general population to be violent over a period of three years, the study found. But the risk for future violence reached the level of statistical significance when mental illness was combined with substance abuse.

Still, the mental illness/substance abuse combination only ranked ninth on the study's list of the top 10 predictors of future violence. The predictors, listed from first to tenth, were: age (younger people are more likely to commit violence); history of violence; gender (males are more prone to violence); history of juvenile detention; divorce or separation in the past year; history of physical abuse; parental criminal history; unemployment in the past year; mental illness with substance abuse; and victimization in the past year.

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Old Schizophrenia Drug Fights Violence as Effectively as Second-Generation Antipsychotics

The newer, atypical antipsychotics were no better than a first-generation agent in reducing violent behavior in schizophrenic patients, researchers here said.

Among 1,445 patients randomly assigned to one of five antipsychotic drugs, the overall proportion showing violent behavior declined from 19% at baseline to 14% after six months on an intent-to-treat basis, with no differences seen between different medications, reported Marvin Swartz, M.D., of Duke University, and colleagues in the July 1 issue of the British Journal of Psychiatry.

They conducted a new analysis of data from the initial randomization phase of the prospective, double-blind Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project, a multi-center trial comparing the effectiveness of different drugs for schizophrenia.

"Contrary to high expectations and some previous research, this study did not show an advantage for second-generation antipsychotics in violence risk reduction when compared with perphenazine, a representative first-generation antipsychotic," the researchers wrote.

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Brain Chemicals Involved In Aggression Identified: May Lead To New Treatments

School shootings. Muggings. Murder. Road rage. After decreasing for more than a decade, the rate of violent crime in the United States has begun to inch up again. According to the FBI's Uniform Crime Reporting Program, violent crime rose 2.3 percent in 2005 and 1.9 percent in 2006, the first steady increase since 1993.

And new studies are helping scientists gain deeper insight into the neurobiology of aggression and violence. One analysis of brain imaging studies has revealed that brain structures involved in making moral judgments are often damaged in violent individuals. Another study involving teenage boys suggests that disruptions in a brain region linked to impulsive, aggressive behavior may underlie a certain type of violent, reactive behavior.

Still other research has shed new light on the role that certain brain chemicals play in aggressive behavior, including in maternal aggression. And new animal studies reveal that aggressive encounters cause changes in the brains of aggressors as well as their victims that increase vulnerability to depression and immune-related illnesses.

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