A meta-analysis of the prediction of violence among adults with mental disorders

The study of the risk for violence among persons with mental disorders has received substantial scientific attention over the past few decades; however, many uncertainties and controversies remain due to the wide disparities in the reported results. Using the state-of-the-art perspective of public health, a meta-analysis was conducted to clarify the ambiguities by synthesizing quantitative findings from 85 research reports (completed between January 1970 and May 2010) on violence risk assessment among mentally disordered adults. Results of this meta-analytic study revealed that the estimates of the prevalence of violence among the psychiatric population varied considerably from 1.1% to 78.4% with a combined mean rate of 19.3% (95% CI = 15.7-23.5%, k = 68, N = 160,206). Additionally, a total of 290 effect sizes were computed for 36 risk factors of interest and their relative strength in relation to violence was compared. Most importantly, this review demonstrated that mentally disordered patients were no more likely than their non-mentally disordered counterparts to commit violent acts. Overall, the findings have significant implications for clinicians, policy makers, researchers, and the general public, including the psychiatric patients. Lastly, a Global Public Health-Comprehensive Meta-Analysis (GPH-CMA) approach is proposed as a new direction for risk assessment and management