Schizophrenia increases the risk of offending. Recidivism rates are significant.

Identifying general and violent recidivism risk factors in schizophrenia patients.

We conducted a case control study. All included patients were admitted, at least once, to the forensic psychiatry department in Razi Hospital between January 1st, 1985 and December 31st, 2014 after a decision of irresponsibility by reason of insanity. All those who reoffended during this period were considered as cases. A draw was performed to create the control group. Both groups were matched according to their first offenses’ types as well as to their ages. A multivariate analysis was performed.

We included 25 cases and 38 controls. Eight recidivism risk factors were identified. Living in urban poor neighbourhoods (P=0.023; OR=4.86), having been unemployed (P=0.042; OR=2.18) and not having lived with the family (P=0.039; OR=1.36) after discharge were considered as risk factors. The same applied to alcohol (P=0.026; OR=4.89) and cannabis use disorders (P=0.018; OR=6.01). A hospitalization shorter than 6 months increased the risk by 1.79 (P=0.046). A combination of conventional antipsychotics (P=0.023;OR=4.81) and a poor adherence (P=0.001; OR=10.42) were considered as recidivism risk factors too.

All eight recidivism risk factors are dynamic. This makes recidivism prevention conceivable. Measures involving the patient, the health care system, patients’ families, society and the government should be taken.