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Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses

BACKGROUND: Substance use disorder explains much of the excess risk of violent behaviour in psychotic disorders. However, it is unclear to what extent the pharmacological properties and subthreshold use of illicit substances are associated with violence. METHODS: Individuals with psychotic disorders...

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Detalles Bibliográficos
Autores principales: Lamsma, Jelle, Cahn, Wiepke, Fazel, Seena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525769/
https://www.ncbi.nlm.nih.gov/pubmed/31462346
http://dx.doi.org/10.1017/S0033291719002125
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author Lamsma, Jelle
Cahn, Wiepke
Fazel, Seena
author_facet Lamsma, Jelle
Cahn, Wiepke
Fazel, Seena
author_sort Lamsma, Jelle
collection PubMed
description BACKGROUND: Substance use disorder explains much of the excess risk of violent behaviour in psychotic disorders. However, it is unclear to what extent the pharmacological properties and subthreshold use of illicit substances are associated with violence. METHODS: Individuals with psychotic disorders were recruited for two nationwide projects: GROUP (N = 871) in the Netherlands and NEDEN (N = 921) in the United Kingdom. Substance use and violent behaviour were assessed with standardized instruments and multiple sources of information. First, we used logistic regression models to estimate the associations of daily and nondaily use with violence for cannabis, stimulants, depressants and hallucinogens in the GROUP and NEDEN samples separately. Adjustments were made for age, sex and educational level. We then combined the results in random-effects meta-analyses. RESULTS: Daily use, compared with nondaily or no use, and nondaily use, compared with no use, increased the pooled odds of violence in people with psychotic disorders for all substance categories. The increases were significant for daily use of cannabis [pooled odds ratio (pOR) 1.6, 95% confidence interval (CI) 1.2–2.0), stimulants (pOR 2.8, 95% CI 1.7–4.5) and depressants (pOR 2.2, 95% CI 1.1–4.5), and nondaily use of stimulants (pOR 1.6, 95% CI 1.2–2.0) and hallucinogens (pOR 1.5, 95% CI 1.1–2.1). Daily use of hallucinogens, which could only be analysed in the NEDEN sample, significantly increased the risk of violence (adjusted odds ratio 3.3, 95% CI 1.2–9.3). CONCLUSIONS: Strategies to prevent violent behaviour in psychotic disorders should target any substance use.
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spelling pubmed-75257692020-10-05 Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses Lamsma, Jelle Cahn, Wiepke Fazel, Seena Psychol Med Original Articles BACKGROUND: Substance use disorder explains much of the excess risk of violent behaviour in psychotic disorders. However, it is unclear to what extent the pharmacological properties and subthreshold use of illicit substances are associated with violence. METHODS: Individuals with psychotic disorders were recruited for two nationwide projects: GROUP (N = 871) in the Netherlands and NEDEN (N = 921) in the United Kingdom. Substance use and violent behaviour were assessed with standardized instruments and multiple sources of information. First, we used logistic regression models to estimate the associations of daily and nondaily use with violence for cannabis, stimulants, depressants and hallucinogens in the GROUP and NEDEN samples separately. Adjustments were made for age, sex and educational level. We then combined the results in random-effects meta-analyses. RESULTS: Daily use, compared with nondaily or no use, and nondaily use, compared with no use, increased the pooled odds of violence in people with psychotic disorders for all substance categories. The increases were significant for daily use of cannabis [pooled odds ratio (pOR) 1.6, 95% confidence interval (CI) 1.2–2.0), stimulants (pOR 2.8, 95% CI 1.7–4.5) and depressants (pOR 2.2, 95% CI 1.1–4.5), and nondaily use of stimulants (pOR 1.6, 95% CI 1.2–2.0) and hallucinogens (pOR 1.5, 95% CI 1.1–2.1). Daily use of hallucinogens, which could only be analysed in the NEDEN sample, significantly increased the risk of violence (adjusted odds ratio 3.3, 95% CI 1.2–9.3). CONCLUSIONS: Strategies to prevent violent behaviour in psychotic disorders should target any substance use. Cambridge University Press 2020-09 2019-08-29 /pmc/articles/PMC7525769/ /pubmed/31462346 http://dx.doi.org/10.1017/S0033291719002125 Text en © Cambridge University Press 2019 http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Lamsma, Jelle
Cahn, Wiepke
Fazel, Seena
Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
title Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
title_full Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
title_fullStr Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
title_full_unstemmed Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
title_short Use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
title_sort use of illicit substances and violent behaviour in psychotic disorders: two nationwide case-control studies and meta-analyses
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525769/
https://www.ncbi.nlm.nih.gov/pubmed/31462346
http://dx.doi.org/10.1017/S0033291719002125
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