Schizophrenia Essay, Research Paper

Is Schizophrenia Associated With Crime?

Lisa Moore

Abstract

Many studies have been conducted to examine the relationship, if any, of schizophrenia and crime. Some of these studies have shown that there is a relationship between the two. The general public believes that schizophrenia is associated with violent crime. The perceived link between mental illness and violence could lie in television and films that sensationalize murders committed by mentally ill persons. Studies, results and interpretations are discussed.

Schizophrenia is described as a devastating mental illness and neurological disorder which results from an imbalance of chemicals in the brain. Among other things, this imbalance causes paranoia, disorganized thinking, delusions and hallucinations, including irrational beliefs and seeing things, or hearing voices that are not real. These are known as psychotic symptoms. When someone does not get treatment for these symptoms, they get worse. Some of the signs of schizophrenia show percentages of some of the symptoms that these persons may have. (World Health Organization, 1973b, 1981) (See Table 1.)

Table 1

Signs of Schizophrenia

Description Percentage_

Lack of Insight 97

Auditory Hallucinations 74

Verbal Hallucinations 70

Ideas of Reference 70

Suspiciousness 66

Flat Affect 66

Voices Speaking to Patient 65

Delusional Mood 64

Delusions of Persecution 54

Thought Alienation 52

Thoughts Spoken Aloud 50

Approximately 1% of the population has been diagnosed with schizophrenia. Schizophrenia typically emerges in adolescence, or young adulthood (Lickey & Gordon, 1991). Violence has been reported to be more frequent in patients with serious and persistent mental illness than in the rest of the population. Data from the National Institute of Mental Health Epidemiologic Catchment Area surveys, Swanson and colleagues (1990) showed that the occurrence of major mental illness was associated with increased risk of violent behavior in the preceding year. Active psychiatric symptoms, not merely a history of mental illness, are implicated in this association of mental illness with assaultive behavior (Swanson, 1994). Therefore an understanding of the occurrence of violence in this population requires careful consideration of the psychiatric symptoms. A positive relationship between violence and various psychotic symptoms, such as delusions, hallucinations, and thought disorder has been repeatedly demonstrated in patients with schizophrenia and in those with other psychiatric conditions (Tordiff et al., 1994). To better understand their relationship to violence, we must consider when in the course of mental illness, the violent behavior occurs, as well as the progression or resolution of the underlying symptoms (Krakowski et al., 1986). Often the timing of the violent acts within the course of the illness is not reported; however, many of these previous studies were conducted around the time of hospital admission.

In one study of manic patients (Carlson & Goodwin, 1973) psychopharmacological treatment was postponed so that investigators could observe the natural course of the illness. The initial symptoms, which included irritability and agitation, eventually progressed to open hostility and anger, and the accompanying behavior frequently assualtive and explosive. Violence presumably remits as these acute symptoms improve. One report (Taylor et al.) showed that strong predictors of violence in the mentally ill is the feeling that others are out to harm them and a feeling that their mind is dominated by forces beyond their control or that thoughts are being put into their head. Command hallucinations, in which voices tell the schizophrenic person what to do, may be compelling predictors of violence. Approximately 40% of people with schizophrenia attempt suicide and 10% complete the act, apparently as a result of the voices or to escape the suffering caused by the voices and other symptoms. By far, the majority of serious violent acts by persons with schizophrenia are directed toward themselves. In another study (Virkkunen, 1974) differentiated between two groups of violent schizophrenic patients. In one group, violent acts occurred during psychotic episodes; were accompanied by hallucinations, delusions, and other positive symptoms; were seldom preceded by a hostile attitude toward the victim. In the other group, the assaults were not restricted to psychotic episodes; hostility and resentment toward the victims had existed for a long time and eventually culminated in acts of violence.

Another study (Humphreys et al., 1992) among a group of 253 patients with first-episode schizophrenia, 53 behaved in a threatening manner. In about half the cases, this behavior was a direct result of psychotic symptoms, usually delusions. The joint study by Indiana University and Columbia University found that 12.1% of Americans surveyed in 1996, perceived people with mental illnesses as violent, dangerous, frightening. That s nearly twice the 7.2% who expressed such concerns in 1950.

Spry (1984) reviews the evidence on the incidence of schizophrenia and crime and notes a division in research finding with studies non-disordered offender groups the incidence of schizophrenia is around 1% (although P.J. Taylor s 1986 figures for life-sentenced offenders were substantially higher) with selected samples of offenders referred for psychiatric treatment. Typically having committed serious offenses, the incidence is much higher.

In patients with schizophrenia, violence is also related to various measures of neurological dysfunction, including electroencephographic abnormalities (Heath, 1982) and neuropsychological impairment (Adams et al., 1990). Persistently violent patients with schizophrenia presented with more neurological impairment than nonviolent and transiently violent patients (Krakowski et al., 1989).

All of these studies indicate some relationship between schizophrenia and crime, but most are nonviolent crimes. Treatment is a very important factor for persons with schizophrenia to ensure their symptoms are controlled. Most individuals with schizophrenia are not violent; more typically, they are withdrawn and prefer to be left alone. Most violent crimes are not committed by persons with schizophrenia, and most persons with schizophrenia do not commit violent crimes. Substance abuse significantly raises the rate of violence in people with schizophrenia, but also people who do not have any mental illness (National Institute of Mental Health, 1999).

References

Psychiatric Services. (2001). Publication American Psychiatric Association (Vol.52 pp. 75-80)

Schizophrenia Bulletin. (2001). (Vol. 276 pp.103-113). U.S. Superintendent of Documents

(November, 1997). Statement on Violence Associated with Schizophrenia

[Online]. Available: http://www.t2.net/schask/violence.htm