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Violence as a Social, Clinical, and Forensic Problem

  • Bernardo CarpinielloEmail author
  • Claudio Mencacci
  • Antonio Vita
Chapter
First Online:
Part of the Comprehensive Approach to Psychiatry book series (CAP, volume 1)

Abstract

Mental disorders, in particular when severe and in comorbidity with personality and/or substance-use disorders, are associated with a greater risk of aggressive behaviors, although a series of biographical and contextual factors play a fundamental role in explaining violent acts. Psychopathology, however, exposes those who suffer from mental disorders to the risk of being a victim of violence than to being author of violence. While contributing to a minimum extent to the overall violence in modern societies, aggression linked to psychopathology is associated with a disproportionate social alarm, which is fueled by the media and originates from the persistent negative stereotype about the intrinsic dangerousness of mental illness, which in turn feeds consistently stigmatizing attitudes. The process of progressive deinstitutionalization which took place in many countries has been associated sometimes with an increase in violent behaviors, although a consistent body of data from other countries seem to contradict this equation. However, aggression due to mental health problems contributes significantly to the family burden and the need to support families in the context of community-based systems of care. On a clinical level, both in hospital and extra-hospital contexts, the assessment of risk of violence and its prevention is an extremely difficult, at times impossible, task given the multiplicity and complexity of factors involved. Violent behavior is certainly among the major determinants of hospital admissions, especially involuntary admissions, of treatments without consent and/or coercive measures, all of which give rise to a series of human, ethical, and legal issues. The abolition, or at least the limitation, of involuntary hospitalizations and coercive measures represents an important challenge for current psychiatry, being a goal that many countries strive to pursue. On a forensic level, the management and treatment of people with mental disorders who commit crimes still represents a relevant challenge requiring new solutions, in the light of the unsatisfactory results of the treatment systems traditionally adopted by most countries, based on secure forensic psychiatric hospitals.

Keywords

Mental disorders Violence Social consequences Clinical management Forensic aspects 
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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Bernardo Carpiniello
    • 1
    Email author
  • Claudio Mencacci
    • 2
  • Antonio Vita
    • 3
  1. 1.Public Health-Unit of Psychiatry and Psychiatric Clinic, Department of Medical SciencesUniversity Hospital of CagliariCagliariItaly
  2. 2.Department of NeurosciencesFatebenefratelli and Sacco HospitalMilanItaly
  3. 3.Division of Psychiatry, Department of Clinical and Experimental SciencesSpedali Civili, University of BresciaBresciaItaly

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