0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
Patterns of Justice Involvement Among Adults With Schizophrenia and Bipolar Disorder: Key Risk Factors
Allison G. Robertson, Ph.D., M.P.H.; Jeffrey W. Swanson, Ph.D.; Linda K. Frisman, Ph.D.; Hsiuju Lin, Ph.D.; Marvin S. Swartz, M.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300044
View Author and Article Information

Dr. Robertson, Dr. Swanson, and Dr. Swartz are with the Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (e-mail: allison.gilbert@duke.edu). Dr. Frisman and Dr. Lin are with the School of Social Work, University of Connecticut, West Hartford.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  Adults with serious mental illness have a relatively high risk of criminal justice involvement. Some risk factors for justice involvement are known, but the specific interaction of these risk factors has not been examined. This study explored the interaction of gender, substance use disorder, and psychiatric diagnosis among patients with schizophrenia or bipolar disorder to identify subgroups at higher risk of justice involvement.

Methods  Administrative service records of 25,133 adults with schizophrenia or bipolar disorder who were clients of Connecticut’s public behavioral health system during 2005–2007 were merged with state records of criminal convictions, incarceration, and other measures of justice involvement. The main effects and the effects of interactions of gender, substance use disorder, and psychiatric diagnosis on risk of justice involvement (“offending”) were estimated by using multivariable logistic regression.

Results  Men with bipolar disorder and co-occurring substance use disorder had the highest absolute risk of offending in every category of justice involvement. For both men and women, bipolar disorder was associated with an increased risk of offending versus schizophrenia, but the increase was significantly greater for women. Substance use disorder also increased risk of offending more among women than men, especially among those with schizophrenia.

Conclusions  Men and women with bipolar disorder and substance use disorders have much higher risk of justice involvement than those with schizophrenia, especially those without a substance use disorder. Research is needed to validate these effects in other populations and specify risk factors for justice involvement among adults with mental illness.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Figure 1 Predicted probabilities of any criminal justice involvement among 25,133 adults with schizophrenia or bipolar disorder
Anchor for Jump
Table 1Characteristics of 25,133 adults with a mental illness and a co-occurring substance use disorder or with mental illness alonea
Table Footer Note

a Chi square tests were used to examine differences in proportions, and t tests were used to examine differences in means.

Table Footer Note

*p<.05, **p<.01, ***p<.001

Anchor for Jump
Table 2Outcomes of criminal justice involvement among 6,904 adults with mental illness and a co-occurring substance use disorder or with mental illness alonea
Table Footer Note

a Chi square tests were used to examine differences in proportions, and t tests were used to examine differences in means.

Table Footer Note

b Include criminal trespass, breach of peace, and criminal mischief

Table Footer Note

c Include violation of probation or parole and failure to appear

Table Footer Note

*p<.01, **p<.001

Anchor for Jump
Table 3Estimated interaction effects of primary diagnosis and co-occurring substance use disorder on odds of justice involvement, by gendera
Table Footer Note

a The models include covariates to control for effects of race-ethnicity and age. The reference group is schizophrenia alone.

Anchor for Jump
Table 4Estimated interaction effects of primary diagnosis and co-occurring substance use disorder on odds of conviction for various types of crime, by gendera
Table Footer Note

a The models include covariates to control for effects of race-ethnicity and age. The reference group is schizophrenia alone.

Table Footer Note

*p<.05, **p<.01, ***p<.001

+

References

Steadman  HJ;  Osher  FC;  Robbins  PC  et al:  Prevalence of serious mental illness among jail inmates.  Psychiatric Services 60:761–765, 2009
[CrossRef] | [PubMed]
 
Kessler  RC;  Chiu  WT;  Demler  O  et al:  Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.  Archives of General Psychiatry 62:617–627, 2005
[CrossRef] | [PubMed]
 
Glaze LE: Correctional populations in the United States, 2009. Bureau of Justice Statistics Bulletin, Dec 2010. Available at www.bjs.gov/content/pub/pdf/cpus09.pdf
 
Lamb  HR;  Weinberger  LE;  Gross  BH:  Mentally ill persons in the criminal justice system: some perspectives.  Psychiatric Quarterly 75:107–126, 2004
[CrossRef] | [PubMed]
 
Lurigio  AJ:  People with serious mental illness in the criminal justice system: causes, consequences, and correctives.  Prison Journal 91:66S–86S, 2011
[CrossRef]
 
Swanson  JW;  Van Dorn  RA;  Swartz  MS  et al:  Alternative pathways to violence in persons with schizophrenia: the role of childhood antisocial behavior problems.  Law and Human Behavior 32:228–240, 2008
[CrossRef] | [PubMed]
 
Abram  KM;  Teplin  LA:  Co-occurring disorders among mentally ill jail detainees: implications for public policy.  American Psychologist 46:1036–1045, 1991
[CrossRef] | [PubMed]
 
Abram  KM:  The problem of co-occurring disorders among jail detainees: antisocial disorder, alcoholism, drug abuse, and depression.  Law and Human Behavior 14:333–345, 1990
[CrossRef]
 
Abram  KM;  Teplin  LA;  McClelland  GM:  Comorbidity of severe psychiatric disorders and substance use disorders among women in jail.  American Journal of Psychiatry 160:1007–1010, 2003
[CrossRef] | [PubMed]
 
Swanson  JW;  Frisman  LK;  Robertson  AG  et al:  Costs of criminal justice involvement among persons with serious mental illness in Connecticut.  Psychiatric Services 64:630–637, 2013
[CrossRef] | [PubMed]
 
Draine  J;  Solomon  P;  Meyerson  A:  Predictors of reincarceration among patients who received psychiatric services in jail.  Hospital and Community Psychiatry 45:163–167, 1994
[PubMed]
 
Wilson  AB;  Draine  J;  Hadley  T  et al:  Examining the impact of mental illness and substance use on recidivism in a county jail.  International Journal of Law and Psychiatry 34:264–268, 2011
[CrossRef] | [PubMed]
 
Fazel  S;  Lichtenstein  P;  Grann  M  et al:  Bipolar disorder and violent crime: new evidence from population-based longitudinal studies and systematic review.  Archives of General Psychiatry 67:931–938, 2010
[CrossRef] | [PubMed]
 
Swanson  JW;  Holzer  CE  III;  Ganju  VK  et al:  Violence and psychiatric disorder in the community: evidence from the Epidemiologic Catchment Area surveys.  Hospital and Community Psychiatry 41:761–770, 1990
[PubMed]
 
Link  B;  Stueve  A:  Psychotic symptoms and the violent/illegal behavior of mental patients compared to community controls; in  Violence and Mental Disorder: Developments in Risk Assessment . Edited by Monahan  J;  Steadman  H.  Chicago,  University of Chicago Press, 1994
 
Steadman  HJ;  Mulvey  EP;  Monahan  J  et al:  Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods.  Archives of General Psychiatry 55:393–401, 1998
[CrossRef] | [PubMed]
 
Arseneault  L;  Moffitt  TE;  Caspi  A  et al:  Mental disorders and violence in a total birth cohort: results from the Dunedin Study.  Archives of General Psychiatry 57:979–986, 2000
[CrossRef] | [PubMed]
 
Van Dorn  R;  Volavka  J;  Johnson  N:  Mental disorder and violence: is there a relationship beyond substance use? Social Psychiatry and Psychiatric Epidemiology 47:487–503, 2012
[CrossRef] | [PubMed]
 
Swartz  MS;  Swanson  JW;  Hiday  VA  et al:  Violence and severe mental illness: the effects of substance abuse and nonadherence to medication.  American Journal of Psychiatry 155:226–231, 1998
[PubMed]
 
Swanson  JW;  Swartz  MS;  Van Dorn  RA  et al:  A national study of violent behavior in persons with schizophrenia.  Archives of General Psychiatry 63:490–499, 2006
[CrossRef] | [PubMed]
 
Fazel  S;  Långström  N;  Hjern  A  et al:  Schizophrenia, substance abuse, and violent crime.  JAMA 301:2016–2023, 2009
[CrossRef] | [PubMed]
 
Farnworth  M;  Teske  R:  Gender differences in felony court processing: three hypotheses of disparity.  Women and Criminal Justice 6:23–44, 1995
[CrossRef]
 
Hagan  J:  Destiny and drift: subcultural preferences, status attainments, and the risks and rewards of youth.  American Sociological Review 56:567–582, 1991
[CrossRef]
 
Sabol  WJ;  Minton  TD:  Jail Inmates at Midyear 2007 .  Washington, DC,  Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2008
 
Grann  M;  Danesh  J;  Fazel  S:  The association between psychiatric diagnosis and violent re-offending in adult offenders in the community.  BMC Psychiatry 8:92, 2008
[CrossRef] | [PubMed]
 
Mueser  KT;  Gottlieb  JD;  Cather  C  et al:  Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: clinical, functional, and family relationship correlates.  Psychosis 4:52–62, 2012
[CrossRef] | [PubMed]
 
Swann  AC:  Antisocial personality and bipolar disorder: interactions in impulsivity and course of illness.  Neuropsychiatry 1:599–610, 2011
[CrossRef] | [PubMed]
 
Henry  C;  Mitropoulou  V;  New  AS  et al:  Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences.  Journal of Psychiatric Research 35:307–312, 2001
[CrossRef] | [PubMed]
 
Fan  AH;  Hassell  J:  Bipolar disorder and comorbid personality psychopathology: a review of the literature.  Journal of Clinical Psychiatry 69:1794–1803, 2008
[CrossRef] | [PubMed]
 
Swann  AC;  Lijffijt  M;  Lane  SD  et al:  Criminal conviction, impulsivity, and course of illness in bipolar disorder.  Bipolar Disorders 13:173–181, 2011
[CrossRef] | [PubMed]
 
Baillargeon  J;  Binswanger  IA;  Penn  JV  et al:  Psychiatric disorders and repeat incarcerations: the revolving prison door.  American Journal of Psychiatry 166:103–109, 2009
[CrossRef] | [PubMed]
 
Volavka  J;  Swanson  J:  Violent behavior in mental illness: the role of substance abuse.  JAMA 304:563–564, 2010
[CrossRef] | [PubMed]
 
Stone  AM;  Greenstein  RA;  Gamble  G  et al:  Cocaine use by schizophrenic outpatients who receive depot neuroleptic medication.  Hospital and Community Psychiatry 44:176–177, 1993
[PubMed]
 
Shaner  A;  Khalsa  ME;  Roberts  L  et al:  Unrecognized cocaine use among schizophrenic patients.  American Journal of Psychiatry 150:758–762, 1993
[PubMed]
 
Drake  RE;  Alterman  AI;  Rosenberg  SR:  Detection of substance use disorders in severely mentally ill patients.  Community Mental Health Journal 29:175–192, discussion 193–194, 1993
[CrossRef] | [PubMed]
 
Junginger  J;  Claypoole  K;  Laygo  R  et al:  Effects of serious mental illness and substance abuse on criminal offenses.  Psychiatric Services 57:879–882, 2006
[CrossRef] | [PubMed]
 
Skeem  J;  Eno Louden  J;  Manchak  S  et al:  Social networks and social control of probationers with co-occurring mental and substance abuse problems.  Law and Human Behavior 33:122–135, 2009
[CrossRef] | [PubMed]
 
Bonta  J;  Law  M;  Hanson  K:  The prediction of criminal and violent recidivism among mentally disordered offenders: a meta-analysis.  Psychological Bulletin 123:123–142, 1998
[CrossRef] | [PubMed]
 
Girard  L;  Wormith  J:  The predictive validity of the Level of Service Inventory-Ontario Revision on general and violent recidivism among various offender groups.  Criminal Justice and Behavior 31:150–181, 2004
[CrossRef]
 
Douglas  KS;  Guy  LS;  Hart  SD:  Psychosis as a risk factor for violence to others: a meta-analysis.  Psychological Bulletin 135:679–706, 2009
[CrossRef] | [PubMed]
 
References Container
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Articles
Books
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 38.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 38.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 16.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 33.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 8.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles