Manic episodes are present in many individuals with schizophrenia, bipolar, and other forms of psychosis. Increased irritability, excitement, and agitation can lead to difficulty with communication and can present challenges in social situations. Further, this type of behavior, coupled with reduced emotional control, could place individuals with schizophrenia and other psychotic conditions at risk for victimization. That was the main finding from a recent study conducted by Federico Fortugno of the Neurosciences, Mental Health, and Sensory Functions Department at the School of Medicine and Psychology at Sapienza University in Italy. Because there is an abundance of literature examining the factors that predict violent behavior and perpetration in people with psychosis but little research exploring factors that predict victimization, Fortugno wanted to research what specific symptoms of schizophrenia and other related issues were common among those who reported a history of victimization.
For his study, Fortugno interviewed over 900 adults between the ages of 18 and 65 during the first week following their involuntary hospital admittance. The participants were English and European, and each was evaluated for symptom severity, mania, violent behaviors, and victimization. Fortugno chose to look at both perpetration and victimization to determine if the predicting symptoms overlapped. He found that nearly 40% of the English and nearly one-third of the European participants all reported being a victim of a violent crime in the year prior to hospitalization.
The main finding was the presence of manic symptoms in all of the participants reporting victimization. The more severe the mania, the more likely the participant had a history of victimization. However, manic symptoms also led to increased reporting of perpetrating violent behavior as well.
Another factor that was common among those reporting victimization was unemployment. Although men were more likely to perpetrate violence than women, the men and women without steady employment had equal rates of victimization. Fortugno believes the lack of a structured environment and lower functioning capacity could explain that finding. Overall, these results add to the scant literature examining symptoms that predict victimization in mentally ill individuals. This study clearly shows that high levels of mania put individuals with schizophrenia at greater risk for being hurt. Fortugno added, “Such symptoms should be specifically considered in risk assessments.”
- Fortugno, F., Katsakou, C., Bremner, S., Kiejna, A., Kjellin, L., et al. (2013). Symptoms associated with victimization in patients with schizophrenia and related disorders. PLoS ONE 8(3): e58142. doi:10.1371/journal.pone.0058142
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