Abstract

Assaultive acts committed by people with a mental illness is a major public health issue that affects patients with their families, law enforcement authorities, and the public at large. Failure to provide treatment is in fact a major predictor of assaultive acts in patients with schizophrenia living in the community. Considering that the indigenous ethnic groups of Central Asia have similar sociocultural characteristics, these factors may be reflected in individuals with schizophrenia who have committed serious assaultive acts in Uzbekistan.Objectives: The aim of the work was to identify the sociocultural and clinical characteristics of schizophrenic representatives of indigenous ethnic groups of Central Asia who have committed violent crimes in Uzbekistan and have been found insane in regard to their offence, and to compare these subjects to ones belonging to the other ethnic groups.Material and methods: The data were collected in 2010–2013 in the Tashkent High Security Psychiatric Hospital via face-to-face interviews and also from the patients’ charts and from forensic psychiatric examination statements.Results: The sample consisted of 201 individuals. The sample was 90.1 percent (n = 181) male, with a predominance of the paranoid schizophrenia subtype according to the ICD-10 criteria. Of the subjects, 174 ones (86.6%) were representatives of the indigenous ethnic groups of Central Asia, and 27 ones (13.4%) were representatives of other ethnic groups. The duration of illness among the subjects belonging to the indigenous ethnic groups of Central Asia was less than in the other group; the individuals were rarely referred to psychiatric care because of the popularity of alternative medicine and the stigma attached to mental illness. A positive correlation between violence and various psychotic symptoms, such as delusions, hallucinations, and thought disorder, has also been demonstrated in this group.Conclusions: Sociocultural characteristics, such as delayed referral for psychiatric care because of the popularity of alternative medicine and the stigma attached to mental illness among the indigenous ethnic groups of Central Asia, frequently factor into committing serious acts of assault because of developing psychotic symptoms at the early stages of disease despite their sufficient socioenvironmental adaptation.

Highlights

  • Assaultive acts committed by people with a mental illness is a major public health issue that affects patients with their families, law enforcement authorities, and the public at large

  • The sample was 90.1 percent (n = 181) male, with a predominance of the paranoid schizophrenia subtype according to the ICD-10 criteria

  • The duration of illness among the subjects belonging to the indigenous ethnic groups of Central Asia was less than in the other group; the individuals were rarely referred to psychiatric care because of the popularity of alternative medicine and the stigma attached to mental illness

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Summary

Introduction

Assaultive acts committed by people with a mental illness is a major public health issue that affects patients with their families, law enforcement authorities, and the public at large. The higher risk of assaultive acts among patients with schizophrenia is reflected by the fact that they make up about a half of all patients in forensic detention due to insanity (Beaudoin, 1993). Failure to provide treatment is a major predictor of assaultive acts in patients with schizophrenia living in the community. The study in England and Wales has found that 42% of individuals with schizophrenia who committed homicides had never been referred to psychiatric care prior to their offence (Meehan et al, 2006). The study found that a larger proportion of homicide in first-episode psychosis correlates with a longer duration of untreated psychosis (Large & Nielssen, 2008)

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