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Review Article

Dusunen Adam. 2011; 24(3): 222-227


Schizophrenia, violence and homicidal act: assessing the risks, preventive measures and place of clozapine in the treatment

Hasan Belli, Cenk Ural, Melek Kanarya Vardar, Bahar Tezcan.




Abstract

Objective: This review is designed to analyze the potential risk factors and preventive measures involved in homicidal behaviors in schizophrenic individuals and investigate the efficacy of clozapine in preventing these violence behaviors and evaluate the results. Method: For this purpose, the psychiatry literature was comprehensively reviewed. A screening of the articles in the international and national databases, covering the period between 1979 and 2010 was performed. Trials that have contributed to this field were also utilized. Results: Although the risk of homicidal behaviors is higher in the schizophrenic individuals compared to the overall population, little is known about the relevant conditions triggering this act of violence among criminals. The available results suggest that certain factors, including some sociodemographic characteristics, male gender, young age, alcoholism, substance abuse, incompliance with the treatment, fulfillment of the criteria for antisocial personality disorder and paranoid subtype, history of suicidal ideation and attempts, history of frequent hospitalization increase the potential for occurrence for violence episodes. Conclusion: In the clinical practice, the patients with a risk of committing homicide should be detected and monitored closely. The available data show clozapine to be the most rational therapeutical choice in preventing the acts of violence in schizophrenics.

Key words: Schizophrenia, violence, homicide, risk factors, preventive measures, clozapine






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