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METHODS

Subjects Patients who had a history of violent crime in the community were compared with patients who did not have such a history. They were classified as violent or nonviolent on the basis of presence or absence of arrest for violent crime in the community, as obtained through interview and chart review. We included the principal offenses listed as violent crime by the US Department of Justice: murder and non-negligent manslaughter, robbery, assault, and forcible rape. 2’At the time the study was conducted, the subjects were inpatients on the admission wards in two large state psychiatric hospitals. Inclusion criteria included presence of major psychiatric illness, length of present hospitalization of 2 months or less, and age from 18 to 55 years. Patients with significant medical or neurological illness as determined by chart review were excluded. Patients who were physically assaultive in the hospital were included in our study after their first assault and matched to patients with no inpatient assaults on age, race, sex, diagnosis, and length of hospitalization. Because we wanted to further subdivide the inpatient violent group, only every other violent patient was matched.

After complete description of the study to the subjects, written informed consent was obtained. All patients were followed for 4 weeks; control subjects who became physically assaultive during these 4 weeks were excluded. There were 102 patients who met all requirements for participation in the study(signing of consent, 4-week stay in the hospital, and availability of records to check for past criminal violence): 69 patients with inpatient assaults and 33 with no inpatient …