Prevalence of violence to others among individuals with schizophrenia in China: A systematic review and meta-analysis

Yi Guo; Xianmei Yang; Dan Wang; Ruoxin Fan; Yiying Liang; Rongke Wang; Hu Xiang; Yuanyuan Liu; Xiang Liu

doi:10.3389/fpsyt.2022.939329

Prevalence of violence to others among individuals with schizophrenia in China: A systematic review and meta-analysis

Front Psychiatry. 2022 Jul 22:13:939329. doi: 10.3389/fpsyt.2022.939329. eCollection 2022.

Authors

Yi Guo¹, Xianmei Yang², Dan Wang², Ruoxin Fan², Yiying Liang¹, Rongke Wang², Hu Xiang², Yuanyuan Liu¹, Xiang Liu³

Affiliations

¹ Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
² Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China.
³ Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

Abstract

Background: Violence to others (hereinafter referred to as "violence-TO") is common in individuals with schizophrenia. The reported prevalence of violence-TO among schizophrenics ranges widely in existing studies. Improved prevalence estimates and identification of moderators are needed to guide future management and research.

Methods: We searched EBSCO, EMBASE, Medline, PubMed, Science Direct, Web of Science, CNKI, VIP, WANFANG data, and CBM for relevant articles published before June 5, 2022. Meanwhile, violence-TO was summarized into four categories: (a) violence-TO on the reviews of official criminal or psychiatric records (type I); (b) less serious forms of violence-TO (type II); (c) physical acts causing demonstrable harm to victims (type III); (d) homicide (type IV). We did meta-analysis for the above types of violence-TO, respectively, and applied subgroup analyses and meta-regression analyses to investigate the source of heterogeneity.

Results: A total of 56 studies were eligible in this study and 34 of them were high-quality. The prevalence of type I to type IV in individuals with schizophrenia in China was 23.83% (95% CI: 18.38-29.75%), 23.16% (95% CI: 8.04-42.97%), 17.19% (95%CI: 8.52-28.04%), and 0.62% (95% CI: 0.08-1.54%) respectively. The results of the subgroup analysis showed that the prevalence of type I was higher among subjects in the inland than in the coastal non-economic zone, while the prevalence of type III was the highest in the coastal economic zone, followed by the inland region and the lowest in the coastal non-economic zone. The results of multivariate meta-regression analyses showed that: patient source in type I (β = 0.15, P < 0.01), patient source (β = 0.47, P < 0.01), and proportion of male (β = 0.19, P < 0.01) in type II, age (β = 0.25, P < 0.01), and GDP per capita (β = 0.05, P = 0.01) in type III were statistically significant.

Conclusion: The prevalence of different types of violence-TO and their influencing factors varied. Therefore, the authorities should take different management measures. In addition to individual factors, regional factors may also affect violence-TO, which suggests the need for a multi-sectorial approach to prevention and treatment for subjects in different regions and adopting targeted control strategies.

Systematic review registration: [www.ClinicalTrials.gov], identifier [CRD42021269767].

Keywords: meta-analysis; prevalence; schizophreina; spatial distribution; violence.

Publication types

Systematic Review