HISTORY OF VIOLENT BEHAVIOR AND SCHIZOPHRENIA IN DIFFERENT CULTURES -ANALYSES BASED ON THE WHO STUDY ON DETERMINANTS OF OUTCOME OF SEVERE MENTAL-DISORDERS

Background information on patterns and correlates of the violent behav iour of individuals with schizophrenia is largely limited to populatio ns in developed countries. Data from a World Health Organization epide miological study of schizophrenia and related disorders, the Determina nts of Outcome of Severe Mental Disorders (DOSMD), presented an opport unity to study patterns of violence across multinational settings. Met hod Centres in 10 countries participated in the DOSMD study. An incide nce sample of 1017 patients with schizophrenia who had their first-in- lifetime contact with a he ping agency as a result of their psychotic symptoms was obtained. Data were available on their history of violent behaviour, substance use, and demographics. Results The occurrence ra te of assault in the entire cohort was 20.6 per hundred, but the rate was three times higher in the developing countries (31.5 per hundred) than in the developed countries (10.5 per hundred). History of assault was associated with positive symptoms, such as excitement and auditor y hallucinations, and with serious alcohol problems. Conclusions The c ultural context and the specific characteristics of the disease in ind ividuals with schizophrenia may interactively affect rates of violent behaviour.