Childhood experiences of patients with schizophrenia and a history of violence: a special hospital sample

Certain childhood experiences, including deprivation and/or abuse, have been shown to contribute to the development of delinquency and later criminality. Although specific illness factors influence violent or offending behaviour by people with schizophrenia, such childhood experiences may also be relevant. This study examined such factors in a sample of 102 patients with schizophrenia in a special hospital. Information was obtained from the hospital case notes. Experiences of a disordered family were found to be common, particularly for the women. Four main subgroups of patients were identified in terms of childhood experiences. Three groups, accounting for two-thirds of the patients, had experiences of a range of problems in childhood before the manifest onset of schizophrenia. The first included patients with evidence of disorder of conduct but without remarkable environmental disadvantage (primary delinquency), the second those with multiple early environmental problems associated with a variety of personal conduct problems (secondary delinquency) and the third those with predominantly childhood neurotic problems in the absence of obvious family or environmental disturbance. Some 40% of the patients had ‘pure’ schizophrenia, its onset coming after an unremarkable childhood. Membership of one of the delinquency groups was associated with a significantly greater tendency to frequent, repeated violence. Group membership had no bearing on seriousness of violence, but there was a trend for people with ‘pure’ schizophrenia to have committed their index offence (usually the most serious) because of or mainly because of their psychotic symptoms. For patients with evidence of environmental disadvantage, conduct disorder or social difficulties as well as schizophrenia, there are likely to be complex interactions between such factors and symptoms of illness. For those with such experiences treatment is unlikely to be complete without attention to the impact and/or continuity of such problem