Wikiversity:Schizophrenia, Criminality, and its Portrayal in the Media

= Schizophrenia, Criminality, and its Portrayal in the Media =

Crime
The mental disorder of schizophrenia is commonly associated with criminality. Recent research that has examined said relationship between schizophrenia and criminality has revealed that the commitment of crimes by patients with schizophrenia is strongly associated with male sex, being single, refusing to accept treatment, substance abuse, and duration of illness.

Substance Abuse
Substance abuse is a disorder that has been found to be highly comorbid with schizophrenia. It is approximated that around half of patients with a schizophrenia diagnosis also meet the criteria for a dual diagnosis (DD) of schizophrenia and substance use disorder. Aside from the less severe substances of tobacco and caffeine, the substances of alcohol, cannabis, and cocaine comprise the majority of substance abuse cases. In a longitudinal study by Hanna Putkonen, PhD, MD, from the National Institute for Health and Welfare, Finland, over 8000 individuals diagnosed with schizophrenia were tracked for 33 years, as well as their full siblings which served as the control. Schizophrenia was indeed found to be correlated with an increase in violent crime in the study. However, although the risk of an individual with schizophrenia engaging in violent crime was drastically heightened, once individuals with a dual diagnosis of substance abuse were ignored, the difference in risk for violent crime between the control group and the participants with schizophrenia (and no substance abuse) was only slightly higher.

Statistics
People diagnosed with schizophrenia are reported to be 4 to 6 times more prone to resort to violence and criminality than mentally healthy individuals are. Six percent of homicides in Western countries have been found to of been committed by individuals who suffered from schizophrenia.

Based on a 2015 study conducted by Abolfazl Ghoreishi from the Department of Psychiatry at Zanjan University of Medical Sciences in Zanjan, Iran, the following rates across various factors where found amongst 358 participants with schizophrenia.

A closer look in the types of offense committed by those who were shown to have criminal behavior is as follows:

Examples in Popular Culture
An analysis of contemporary movies found that 83% of movie characters with schizophrenia exhibited dangerous or violent behavior towards others and 31% of these violent individuals engaged in homicidal behavior.

Examples in Popular Culture
The 2009 film The Soloist, based on the New York Times bestselling book of the same name, highlights the correlation between schizophrenia and poverty. Nathaniel Ayers (played by Jamie Foxx) is a homeless Juilliard-dropout cellist who was diagnosed with schizophrenia. As journalist Steve Lopez (played by Robert Downey Jr.) chases a news story, he bonds with Nathaniel and is exposed to the struggles that those who are not only impoverished but also suffer from mental illness face on a daily basis. A notable point raised by the film is the difficulty and ethical implications of getting schizophrenia patients to take medication regularly. Although antipsychotic medications have proven to be an effective treatment for many of schizophrenia's more serious symptoms, medication compliance. It is estimated that schizophrenia outpatients taking oral and depot medications have a 1-month to 2-year noncompliance rate of 55%. Additionally, 28% of patients who reduced or stopped taking medications reported financial burden to be the principal factor in their discontinuation. Combined with general lack of access to adequate healthcare for most homeless individuals, it can be extremely difficult for those in poverty like the character of Nathaniel Ayers to get the medications they need.

Unlike stereotypes of violence and criminality, the portrayal of poverty and homelessness in contemporary movies tends to be fairly accurate. Almost half of schizophrenic movie characters are presented as being of low socioeconomic status, which is consistent with published research on the frequency of poverty among those with schizophrenia.

Research
Of all studies of 'schizophrenia' ever conducted, approximately 0.9% were concerned with poverty. The research that has been published overwhelming support the existence of a correlation between schizophrenia and poverty. The Epidemiologic Catchment Area study found that the risk of developing schizophrenia for people in the lowest quartile of socioeconomic status was almost 8 times greater than those in the highest quartile. Additionally, about half of those who meet the criteria for schizophrenia are in the lowest socioeconomic group.

The correlation between schizophrenia and poverty could be bidirectionally causal. Increased difficulty in maintaining employment and reliance on a support network for individuals with schizophrenia makes it more likely that schizophrenic individuals will end up homeless or in poverty. In addition, poverty itself may play a causal role in the development of schizophrenia. A study of the Dutch Hunger Winter in 1944 to 1945 illustrates that children born to mothers that experienced prenatal malnutrition had a significantly higher risk for developing schizophrenia and schizoid personality disorder in adulthood. Additionally, lower occupational status of an individual's father and living in a poorer residential area are associated with significantly increased risk of developing schizophrenia.

The manner in which schizophrenia is both diagnosed and treated suggests class bias, indicating that even mental health professionals can be influenced by the stereotypes and stigmas pushed in the media.

Substance Abuse
Up to 50% of schizophrenia patients meet the criteria for a dual diagnosis of schizophrenia and substance abuse at some point in their lifetime.