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Journal Article

Citation

Elbogen EB, Johnson SC. Lancet Psychiatry 2014; 1(1): 6-8.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/S2215-0366(14)70246-9

PMID

unavailable

Abstract

In their article in The Lancet Psychiatry, Seena Fazel and colleagues 1 argue persuasively that although people with schizophrenia and related disorders are known to be at an increased risk of adverse outcomes (especially violent crime, premature mortality, and death by suicide) compared with the general population, whether this association represents secular trends or is specific to mental health problems is generally unknown. The authors succeed in advancing understanding about this issue. The simultaneous analysis of suicide, premature mortality, and violent crime offers hope for the streamlining of risk assessment for people with schizophrenia and other psychiatric disorders and encourages assessing clinicians to explore several behaviours. Fazel and colleagues' finding that at least three prediagnosis risk factors--drug use disorders, history of violent criminality, and self-harm--increased the risk for several adverse outcomes has implications for practical population-based strategies. Several questions still remain. To what extent the findings are generalisable to other countries remains unclear. Although the authors state that many similarities exist between Sweden and other high-income countries, it is important to note that research indicates a lower than 10% level of unmet treatment needs in Nordic countries in people who have schizophrenia2 and that the authors report absence of differences when inpatients and outpatients were compared. People with schizophrenia in other countries have varying access to treatment, as discussed by Mojtabai and colleagues,3 who noted in a review that roughly 40% of patients with schizophrenia reported they had not received any mental health treatment in the preceding 6-12 months..... 1. S Fazel, A Wolf, C Palm, P Lichtenstein. Violent crime, suicide, and premature mortality in patients with schizophrenia and related disorders: a 38-year total population study in Sweden. Lancet Psychiatry, 1 (2014), pp. 44-54
2. L Hansson, HR Vinding, T Mackeprang, et al. Comparison of key worker and patient assessment of needs in schizophrenic patients living in the community: a Nordic multicentre study. Acta Psychiatr Scand, 103 (2001), pp. 45-51


Language: en

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