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Cited by 634

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Violence and Severe Mental Illness: The Effects of Substance Abuse and Nonadherence to Medication

Swartz, Marvin S., Swanson, Jeffrey W., Hiday, Virginia A., Borum, Randy, Wagner, H. Ryan, Burns, Barbara J.·1998·American Journal of Psychiatry
DOI 10.1176/ajp.155.2.226
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Abstract

OBJECTIVE: Violent behavior among individuals with severe mental illness has become an important focus in community-based care. This study examines the joint effect of substance abuse and medication noncompliance on the greater risk of serious violence among persons with severe mental illness. METHOD: Involuntarily admitted inpatients with severe mental illness who were awaiting a period of outpatient commitment were enrolled in a longitudinal outcome study. At baseline, 331 subjects underwent an extensive face-to-face interview. Complementary data were gathered by a review of hospital records and a telephone interview with a family member or other informant. These data included subjects' sociodemographic characteristics, illness history, clinical status, medication adherence, substance abuse, insight into illness, and violent behavior during the 4 months that preceded hospitalization. Associations between serious violent acts and a range of individual characteristics and problems were analyzed by using multivariable logistic regression. RESULTS: The combination of medication noncompliance and alcohol or substance abuse problems was significantly associated with serious violent acts in the community, after sociodemographic and clinical characteristics were controlled. CONCLUSIONS: Alcohol or other drug abuse problems combined with poor adherence to medication may signal a higher risk of violent behavior among persons with severe mental illness. Reduction of such risk may require carefully targeted community interventions, including integrated mental health and substance abuse treatment.

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Citations

Cites

Research works printed but not linked: 35

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Cited by

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Metadata

Authors
Swartz, M. S., Swanson, J. W., Hiday, V. A., Borum, R., Wagner, H. R., & Burns, B. J.
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
1998-02-01
Volume
155
Issue
2
Pages
226-231
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.155.2.226
OpenAlex
W2099369656
Cited by
634
References
1
FWCI
45.57
Type
journal article
Language
en
Open access
closed

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