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Co-occurring Addictive and Psychiatric Disorders pp 321–333Cite as

Violence and Substance Abuse in Psychotic Patients: A Forensic Psychiatric Perspective

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Abstract

In this chapter, a forensic psychiatric perspective on violent behaviour and substance abuse in psychotic patients will be described. First of all, the prevalence of substance abuse in schizophrenia and other psychotic disorders will be discussed. Next, some clinically important issues will be highlighted, such as the relationship between substance abuse and violence in psychotic disorders, and the impact of the type of substance on violent behaviour. Co-morbidity of substance abuse and a personality disorder in psychotic offenders will be discussed. Psychiatric services tend to separate mental illness and addiction services, despite evidence that more than half of the patients with a psychotic disorder have problems with alcohol and drug use and dependence. That is why substance abusing forensic patients need special attention. This could be achieved by joined-up working together between forensic and addiction services, and by further broadening forensic psychiatry training to include specialism in substance abuse, and vice versa. Finally we will summarize treatment possibilities. In conclusion, substance abuse has an aggravating effect on criminogenic behaviour, depending on the age at first conviction and the diagnosis.

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Author information

Authors and Affiliations

  1. Forensic Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University Hospital (UZA), Antwerp, Belgium

    Kris R. Goethals

  2. GGZWNB, Halsteren, The Netherlands

    Kris R. Goethals

  3. Psychiatric Center Alexian Brothers, Boechout, Belgium

    Lieve De Backer

  4. Forensic Psychiatry, Erasmus Medical Center and Erasmus University, Rotterdam, The Netherlands

    H. J. C. van Marle

Authors
  1. Kris R. Goethals
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  2. Lieve De Backer
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  3. H. J. C. van Marle
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Corresponding author

Correspondence to Kris R. Goethals .

Editor information

Editors and Affiliations

  1. Collaborative Psychiatric Research Institute, Antwerp University PC Alexian Brothers Boechout, Boechout, Belgium

    Geert Dom

  2. Clinical Psychological Service and Department, University Hospital of Psychiatry & University of Bern, Bern, Switzerland

    Franz Moggi

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Goethals, K.R., De Backer, L., van Marle, H.J.C. (2015). Violence and Substance Abuse in Psychotic Patients: A Forensic Psychiatric Perspective. In: Dom, G., Moggi, F. (eds) Co-occurring Addictive and Psychiatric Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45375-5_21

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  • DOI: https://doi.org/10.1007/978-3-642-45375-5_21

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