Evidence has accumulated over the last 40 years indicating increased rates of violent perpetration and being the target of violence among people with mental illness. Landmark data collected in the early 1980s by the Epidemiologic Catchment Area study found a 12-month prevalence of 12% for any type of violence among people with mental disorders, which dropped to 7% if people with comorbid substance abuse (DSM-III) were excluded, compared with 2% in the general population.¹ Similar magnitudes of increased risk have been found in subsequent studies² and meta-analyses,³ although the absolute rates of violence vary, probably because of differences in the populations sampled, outcome measures, and means of ascertainment.⁴ However, despite the greater risk associated with mental disorders, the proportion of violence accounted for by mental disorder is small, with 1-year attributable risk estimated at 4% in the Epidemiologic Catchment Area analyses.¹

在过去的40年中，已经积累了证据，表明暴力行为的发生率不断上升，成为精神疾病患者暴力的目标。流行病学流域地区研究在1980年代初期收集的地标数据发现，精神障碍患者中任何类型的暴力行为在12个月内的流行率为12％，如果同时患有药物滥用合并症（DSM-III），则该比例下降到7％。不包括在内，而普通人群中只有2％。¹在随后的研究²和荟萃分析^3中，也发现了相似的增加风险幅度，尽管绝对暴力发生率有所不同，这可能是由于抽样人群，结果测量和确定手段的差异所致。⁴然而，尽管与精神障碍相关的风险更大，但由精神障碍占暴力的比例却很小，根据流行病学集水区分析，一年可归因的风险估计为4％。^1个