Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders

Lamsma, Jelle ORCID logoORCID:, Yu, Rongqin, Fazel, Seena, van Amelsvoort, Therese, Bartels-Velthuis, Agna, Cahn, Wiepke, de Haan, Lieuwe, Schirmbeck, Frederike and Simons, Claudia (2022) Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders. Scientific Reports, 12 (1) , 461. ISSN 2045-2322 [Article] (doi:10.1038/s41598-021-04266-9)

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Oxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61–0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services.

Item Type: Article
Additional Information: Supplementary Information The online version contains supplementary material available at
Keywords (uncontrolled): Human behaviour, Psychology
Research Areas: A. > School of Law > Criminology and Sociology
Item ID: 34500
Notes on copyright: © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
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Depositing User: Jisc Publications Router
Date Deposited: 11 Jan 2022 10:15
Last Modified: 07 Dec 2022 17:51

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