The association between common mental disorders and violence: to what extent is it influenced by prior victimization, negative life events and low levels of social support?



M. ten Have, R. de Graaf, J. van Weeghel and S. van Dorsselaer

Psychological Medicine / Volume 44 / Issue 07 / May 2014, pp 1485-1498



Background Few studies have been published on the association between mental disorders and violence based on general population studies. Here we focus on different types of violence, adjusting for violent victimization and taking account of the limitations of previous population studies.

Method Data were used from the first two waves of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey of the general population aged 1864 years (n = 6646). Violence was differentiated into physical and psychological violence against intimate partner(s), children or any person(s) in general. DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0).

Results Psychological violence occurs considerably more frequently than physical violence, but both showed almost identical associations with mental disorders. After adjustment for sociodemographic characteristics, most of the main categories of common mental disorders were associated with violence. The strongest associations were found for externalizing disorders (substance use, impulse-control, antisocial personality disorder). After additional adjustment for violent victimization, negative life events and social support, most diagnostic correlates lost their significance whereas substance use (in particular alcohol) disorders were still associated with most types of violence.

Conclusions The increased risk of violent offending among people with common mental disorders, other than substance use disorders, can be attributed to factors other than their mental illness.