Criminal activities and substance use of patients with major affective disorders and schizophrenia: a 2-year follow-up.

BACKGROUND: Compelling findings demonstrate that persons who develop major mental disorders, as compared to those who do not, are at increased risk to commit non-violent and violent crimes. This conclusion has recently been shown to apply to persons with major affective disorders. METHODS: Thirty males with major affective disorders and 74 with schizophrenia were followed for 2 years. At discharge, patients were intensively assessed including diagnoses using SADs and RDC. During follow-up, alcohol and drug use were measured, subjectively and objectively. At discharge, the two groups were similar as to secondary diagnoses of antisocial personality disorder, drug abuse/dependence, socio-demographic characteristics, and criminal history, but more of the patients with major affective disorders than those with schizophrenia had a history of alcohol abuse/dependence. During the follow-up period, the two groups were similar as to rehospitalization, treatment intensity, and substance use. RESULTS: By the end of the follow-up period, 33% of the patients with major affective disorders and only 15% of those with schizophrenia had committed crimes, most violent. Co-morbid antisocial personality disorder was associated with criminality among the patients with schizophrenia but not among those with major affective disorders. Among these latter patients, drug use and the intensity of out-patient care were associated with violent criminality. LIMITATIONS: The small number of subjects limited the conclusions. CONCLUSIONS: Violent behavior among patients with major affective disorders may not be uncommon and may be preventable by out-patient treatment which limits drug use.

Children of parents with bipolar disorder: a metaanalysis of risk for mental disorders.

OBJECTIVE: To compare the prevalence rates of mental disorders among children of parents with bipolar disorder and of parents with no mental disorders. METHOD: Seventeen studies, meeting specific selection criteria, were included in the metaanalyses. Risks for mental disorders among children were estimated by aggregating raw data from the selected studies. RESULTS: Results indicate that in comparison with children of parents with no mental disorders, children of parents with bipolar disorder are 2.7 times more likely to develop any mental disorder and 4.0 times more likely to develop an affective disorder. The metaanalyses indicate that during childhood and adolescence, the risks for any mental disorder and for affective disorders in children are consistently but moderately related to having a parent who suffers from bipolar disorder. CONCLUSIONS: Risk factors that could account for the psychopathology observed in children of bipolar parents are explored.