Prof. Seena Fazel

Talk	The contribution of psychosis to violence
Dates	August 31 - September 2, 2020
Round Table 2	Violence and Aggression: Neurodevelopmental and Psychotic Disorders

Seena Fazel is Professor of Forensic Psychiatry at the University of Oxford, United Kingdom, a Wellcome Trust Senior Research Fellow in Clinical Science, and honorary consultant forensic psychiatrist for Oxford Health NHS Foundation Trust. He works clinically in a local prison. His main research interests are on suicidal behaviour in prisoners, mental health of prisoners, and risk assessment in criminal justice and mental health.

In this presentation, I will summarise evidence on the association between psychosis and violence with emphasis on high quality designs and replicated findings. Relative risks are increased for all violent outcomes in schizophrenia-spectrum disorders and bipolar disorder with elevated odds in the range of 2-5 after adjustment for familial and other sources of confounding. Absolute rates of violent crime over 5 years after diagnosis are around 10% in men with schizophrenia, which are lower in men with bipolar disorder, and typically 1-3% in women with these diagnoses. Past criminality and comorbid substance misuse are strongly predictive of future violence, and a range of other background, clinical and treatment factors have been replicated. Based on the risk factor research, I will discuss the potential role for standardized assessment of violence risk in general psychiatric and first episode psychosis services, and summarise the evidence behind commonly used tools, including a new scalable online risk calculator, OxMIV.