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Violence and psychiatric morbidity in the national household population of Britain: public health implications

Forensic Psychiatry Research Unit, Queen Mary College, University of London

Paul Moran, MD

Institute of Psychiatry, London

Paul Bebbington, PhD

Department of Psychiatry and Behavioural Science, Royal Free and University College Medical School, London

Traolach Brugha, MD

Department of Psychiatry, University of Leicester

Rachel Jenkins, MD and Michael Farrell, MRCPsych

Institute of Psychiatry, London

Glyn Lewis, PhD

Division of Psychiatry, University of Bristol

Nicola Singleton, MSc

Office for National Statistics, London, UK

Correspondence: Professor Jeremy Coid, Forensic Psychiatry Research Unit, St Bartholomew's Hospital,William Harvey House, 61 Bartholomew Close, London ECIA 7BE, UK. Tel: +44(0)2076018138; fax: +44(0)2076017969; email: j.w.coid{at}qmul.ac.uk

Declaration of interest None.

Funded by the Department of Health.

Background It is unclear whether psychiatric morbidity contributes to the small proportion of the population responsible for a large percentage of antisocial behaviour, including violence.

Aims To measure associations between psychiatric morbidity and severity, chronicity and types of victims of violence in the national household population of Britain.

Method Cross-sectional survey of persons in households (n=8397).Data included self-reported location, victims and outcome of violence over the previous 5 years. Diagnoses were determined by computer-assisted interviews.

Results Hazardous drinking was associated with over half of all incidents involving injury. Antisocial personality disorder conveyed an attributable risk of 24% of respondents reporting victim injuries, but screening positive for psychosis conveyed an attributable risk of only 1.2%.

Conclusions The burden of care resulting from violence associated with hazardous drinking supports population interventions. Despite exceptional risks, half of respondents with antisocial personality disorder were not violent, indicating limitations in targeted interventions to detain high-risk individuals.

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