Cues for different diagnostic patterns of interpersonal violence in a psychiatric sample: an observational study

Abstract

Background. Interpersonal violence has increased as a health concern especially in the psychiatry practice over the last decades; nevertheless, most patients with stable mental illness do not present an increased risk of violence and a mental disorder is not a necessary or sufficient cause of violent behaviors. People with mental illness endorse more often a number of risk factors for violence that could confound this association, such as young age and male gender. The aim of this study was to investigate the effect of age, gender, and diagnosis on reported levels of interpersonal violence in a sample of people with severe mental illnesses. Methods. The sample was composed of 160 inpatients: 73 with psychosis, 53 with mood disorder and 34 with personality disorder. All patients enrolled in the study were assessed for experiences of victimization and perpetration of interpersonal violence using the Karolinska Interpersonal Violence Scale interview. Demographic variables were also collected. Results. Violence negatively correlated with age. Compared to males, females were exposed to higher degree of violence (for both victimizations in childhood and adulthood), whereas males were more involved in the perpetration of violence (only for perpetration in childhood). Among diagnoses, personality disorders are associated with higher levels of interpersonal violence. An interaction effect of gender and diagnosis was also observed for expression of violence in adulthood. Distinct patterns of interpersonal violence did emerge for the diagnostic entities with mood disorder showing a victimization pattern, personality disorders a perpetration pattern and psychoses a less defined pattern. Conclusions. The main finding is that psychoses, mood disorders and personality disorders have different patterns of violent experiences when combined with age and gender. This study offers a step towards a better understanding of the extent to which gender and age could affect violent behaviors. Moreover, study findings may increase the comprehension of the reason why some mental disorders, compared to others, are more associated with the risk of victimization or perpetration of violence. These patterns could have pathophysiological or pathoplastic meaning addressing clinical and diagnostic trajectories interacting with other intervening risk factors.