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Thomas Fahy

Publications and source records attributed to Thomas Fahy.

4 recordsLinked to original sources
PubMed2004

Predicting violence in schizophrenia: a prospective study.

BACKGROUND: People with schizophrenia are more violent than the general population, but this increased risk is attributable to the actions of a small subgroup. Identifying those at risk has become an essential part of clinical practice. AIMS: To estimate the risk factors for assault in patients with schizophrenia. METHODS: Two hundred seventy-one patients with schizophrenia were interviewed using an extensive battery of instruments. Assault was measured from multiple data sources over the next 2 years and criminal records were obtained. Multiple sociodemographic and clinical variables measured at baseline were examined as possible predictors of assault during follow-up. RESULTS: Sixty-nine (25%) patients committed assault during the 2-year follow-up. The model that best predicted assault included a history of recent assault (OR 2.33, 95% CI 1.17-4.61), a previous violent conviction (OR 2.02, 95% CI 1.04-3.87), having received special education (OR 2.76, 95% CI 1.22-6.26) and alcohol abuse (OR 3.55, 95% CI 1.24-10.2). CONCLUSIONS: Previously established risk factors including a history of violence and alcohol abuse are replicated in this study. Although low premorbid IQ did not predict violence, a need for special education did.

Adolescent↗
PubMed2002

Violence and schizophrenia: examining the evidence.

BACKGROUND: It is now accepted that people with schizophrenia are significantly more likely to be violent than other members of the general population. A less acknowledged fact is that the proportion of societal violence attributable to schizophrenia is small. AIMS: To critically examine the epidemiological evidence for the association between violence and schizophrenia and estimate the impact of this association on society. METHOD: A selective review of the key literature on the epidemiology of violence and schizophrenia. Population-attributable risks for violence in schizophrenia are calculated from population-based studies. RESULTS: Most studies confirm the association between violence and schizophrenia. Recent good evidence supports a small but independent association. Comorbid substance abuse considerably increases this risk. The proportion of violent crime in society attributable to schizophrenia consistently falls below 10%. CONCLUSIONS: Less focus on the relative risk and more on the absolute risk of violence posed to society by people with schizophrenia would serve to reduce the associated stigma. Strategies aimed at reducing this small risk require further attention, in particular treatment for substance misuse.

Bias↗
PubMedDate not supplied

A comparison of statistical models in predicting violence in psychotic illness.

BACKGROUND: The application of statistical modeling techniques, including classification and regression trees, in the prediction of violence has increasingly received attention. METHODS: The predictive performance of logistic regression and classification tree methods in predicting violence was explored in a sample of patients with psychotic illness. RESULTS: Of 2 logistic regression models, the forward stepwise method produced a simpler model than the full model, but the latter performed better. The performance of the classification tree appeared to be high before cross-validation, but reduced when cross-validated. The standard logistic model was the most robust model. A simplified tree with extra weight given to violent cases was a reasonable competitor and was simple to apply. CONCLUSION: Although classification trees can be suitable for routine clinical practice, because of the simplicity of their decision-making processes, their robustness and therefore clinical utility was problematic in this sample. Further research is required to compare such models in large prospective epidemiologic studies of other psychiatric populations.

Adolescent↗