Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses

Lamsma, Jelle, Cahn, Wiepke, Fazel, Seena, GROUP, investigators and NEDEN, investigators (2019) Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses. Psychological Medicine . ISSN 0033-2917 (doi:10.1017/S0033291719002125)

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Abstract

Background.
Substance use disorder explains much of the excess risk of violent behaviour in psychotic disorders. However, it is unclear to what extent the pharmacological properties and subthreshold use of illicit substances are associated with violence.
Methods.
Individuals with psychotic disorders were recruited for two nationwide projects: GROUP (N = 871) in the Netherlands and NEDEN (N = 921) in the United Kingdom. Substance use and violent behaviour were assessed with standardized instruments and multiple
sources of information. First, we used logistic regression models to estimate the associations of daily and nondaily use with violence for cannabis, stimulants, depressants and hallucinogens in the GROUP and NEDEN samples separately. Adjustments were made for
age, sex and educational level. We then combined the results in random-effects meta-analyses.
Results.
Daily use, compared with nondaily or no use, and nondaily use, compared with no use, increased the pooled odds of violence in people with psychotic disorders for all substance categories. The increases were significant for daily use of cannabis [pooled odds ratio (pOR) 1.6, 95% confidence interval (CI) 1.2–2.0), stimulants (pOR 2.8, 95% CI 1.7–4.5) and depressants (pOR 2.2, 95% CI 1.1–4.5), and nondaily use of stimulants (pOR 1.6, 95% CI 1.2–2.0) and hallucinogens (pOR 1.5, 95% CI 1.1–2.1). Daily use of hallucinogens, which could only be analysed in the NEDEN sample, significantly increased the risk of violence (adjusted odds ratio 3.3, 95% CI 1.2–9.3).
Conclusions.
Strategies to prevent violent behaviour in psychotic disorders should target any substance use.

Item Type: Article
Research Areas: A. > School of Law > Criminology and Sociology
Item ID: 27901
Notes on copyright: COPYRIGHT: © The Author(s) 2019
Useful Links:
Depositing User: Jelle Lamsma
Date Deposited: 18 Oct 2019 10:11
Last Modified: 18 Oct 2019 10:11
URI: https://eprints.mdx.ac.uk/id/eprint/27901

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