Paranoid Ideation and Violence: Meta-analysis of Individual Subject Data of 7 Population Surveys.
Paranoid Ideation and Violence: Meta-analysis of Individual Subject Data of 7 Population Surveys.
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DOI：
10.1093/schbul/sbw006
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发表时间：
2016-07
影响因子：
6.6
通讯作者：
Keers R
中科院分区：
文献类型：
--
作者：
Coid JW;Ullrich S;Bebbington P;Fazel S;Keers R
精神病和暴力之间的联系是否是由于共存的物质滥用和非精神病患者风险增加的因素引起的，这一点存在争议。最近在临床样本中的研究表明偏执妄想的独立影响。研究结果表明，在一般人群中，精神病连续体上的个人精神病样经历与暴力有关;目前尚不清楚这种关联是否是由于精神病合并症。我们汇总了7项英国普通人群调查（n = 23444）的数据，并对个体受试者数据进行了荟萃分析。进行了进一步的荟萃分析，以确定异质性。主要暴露变量：5种精神病样经历和精神病的分类测量。科摩罗是通过标准化的自我报告工具建立的。收集了关于暴力、严重程度和受害者的信息。偏执意念与暴力（AOR 2.26，95%CI 1.75-2.91），严重程度和频率相关，即使在控制其他精神病样经历的影响时。相关性不能用包括药物依赖在内的合并症来解释。精神障碍与暴力和伤害的肇事者，但协会解释了偏执的想法。调整后，轻躁狂、思想插入、幻觉和暴力之间的个体关联不显著，只有在与反社会人格障碍共病时才显著相关。奇怪的经历只与亲密伴侣暴力有关。一般人群中精神病连续体的偏执意念与暴力有关。科摩罗解释了所有其他关联。进一步的调查应确定社区中的偏执狂是否需要预防性干预，类似于精神卫生服务。然而，风险大大增加了精神病样的经验，共同发生的反社会人格障碍。
There is controversy whether associations between psychosis and violence are due to coexisting substance misuse and factors increasing risk in nonpsychotic persons. Recent studies in clinical samples have implicated independent effects of paranoid delusions. Research findings suggest that individual psychotic-like-experiences on the psychosis continuum in the general population are associated with violence; it remains unclear whether this association is due to psychiatric comorbidity. We pooled data from 7 UK general population surveys (n = 23 444) and conducted a meta-analysis of individual subject data. Further meta-analyses were performed to identify heterogeneity. Main exposure variables: 5 psychotic-like-experiences and a categorical measure of psychosis. Comorbidity was established through standardized self-report instruments. Information was collected on violence, severity, victims. Paranoid ideation was associated with violence (AOR 2.26, 95% CI 1.75–2.91), severity and frequency, even when controlling for effects of other psychotic-like-experiences. Associations were not explained by comorbid conditions, including substance dependence. Psychotic disorder was associated with violence and injury to the perpetrator but associations were explained by paranoid ideation. Individual associations between hypomania, thought insertion, hallucinations, and violence were nonsignificant after adjustments, and significantly associated only when comorbid with antisocial personality disorder. Strange experiences were only associated with intimate partner violence. Paranoid ideation on a psychosis-continuum in the general population was associated with violence. All other associations were explained by comorbidity. Further investigation should determine whether paranoid ideation among persons in the community require preventive interventions, similar to those presenting to mental health services. Nevertheless, risks are considerably increased for psychotic-like-experiences with co-occurring antisocial personality disorder.