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Article   |    
Assessing the Evidence of a Link Between Mental Illness and Violence
Edward P. Mulvey
Psychiatric Services 1994; doi:
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Preparation of this paper was partly supported by funding from the violence and traumatic stress branch of the National Institute of Mental Health (grant MH-40030-08) and the U. S. Secret Service. The author thanks Charles W. Lidz, Ph.D., and William Gardner, Ph.D., for many of the ideas presented here and Jeffrey W. Swanson, Ph.D., for his critique of an earlier version.

Western Psychiatric Institute and Clinic of the University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213

1994 by the American Psychiatric Association

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The relationship of mental illness and violence is an issue of longstanding clinical and policy importance, and recent research on this association has sparked renewed debate. The author formulates six statements on the association that seem warranted by recent investigations and reviews the research evidence. In general, contrary to findings of earlier research, an association does appear to exist between mental illness and the likelibood of being involved in violent incidents. A dual diagnosis of mental illness and substance abuse probably significantly increases the risk for violence, and the association between mental illness and violence is probably significant even when demographic characteristics are taken into account. Given the considerable limitations of current research, priorities for future research include attention to the strength oftbe association for individual subjects, inclusion of adequate comparison groups of non-mentally-ill persons and a broad range of variables, and intensive studies of repetitively violent individuals over time.

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