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"Treatment halves violent crime"

Professor Paul Lichtenstein at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet and his research group have studied over 82,000 Swedes with a psychiatric diagnosis, their medication and whether they were convicted of violent crime between 2006 and 2009. He can prove that treatment with anti-psychotic drugs and mood stabilizers reduce the risk of violent crime.

Professor Paul Lichtenstein. Photo: Ulf Sirborn

Are mentally ill people more violent than other people?

"Yes, people diagnosed as schizophrenic are three to four times more likely to be convicted of violent crimes. Even those with bipolar disorder have an increased risk."

How does treatment affect violent crimes?

"When diagnosed schizophrenics were given anti-psychotic drugs, violent crime was reduced by almost 50%. Almost the same reduction was achieved with mood stabilizing drugs."

That is quite a lot, isn't it?

"It is a huge amount. If you could reduce crime by 50% through political means, the achievement would be considered as very large."

What does this tell us about violent crimes committed by mentally ill people? Could you call it an effect of inadequate treatment?

"Yes, you could perhaps say that. But a better way of putting it is perhaps that our results suggest half of the violent crimes committed by people with psychotic diseases could have been prevented with treatment.

We do not medicate to reduce crime, we medicate to alleviate psychotic diseases."

What do you think these results should lead to?

"We should probably not exaggerate the importance of this finding. It is one more thing to take into consideration before making a decision on treatment. But there are many things that need to be taken into account, such as the patients' own wishes, side-effects, whether they become overweight, what other resources are available, and so on. It is not only the tendency to crime that determines whether a patient is given treatment. We do not medicate to reduce crime, we medicate to alleviate psychotic diseases."

Text: Fredrik Hedlund, first published in Medical Science issue 3, 2014.