Schizophrenia during pregnancy triples the risk of interpersonal violence

There are many opportunities for healthcare providers to intervene and prevent harm to these patients.

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Schizophrenia is associated with an increased risk of experiencing interpersonal violence. Little is known about the risk, specifically around the time of pregnancy.

Compared to individuals without schizophrenia, pregnant and postpartum people with schizophrenia have a risk of visiting the emergency room due to interpersonal violence that is more than three times higher.

Interpersonal violence can be physical, sexual, or psychological abuse by a relative, close friend, acquaintance, or stranger.

Lead author Kelly Leslie, a fourth-year psychiatry resident at the University of Toronto, said, “Though we found a threefold increased risk for individuals with schizophrenia, we also found that most people, both with and without schizophrenia, are screened for interpersonal violence during pregnancy.”

“This suggests there are many opportunities for health care providers to intervene and prevent harm to these patients and their children.”

In comparison to women without significant mental illness, women with schizophrenia have a risk of experiencing physical or sexual violence of roughly 1 in 5 (20.7%) throughout their lifetime. Regarding their danger during the prenatal period, however, little is known.

The study included more than 1.8 million pregnant people aged 15–49 years, of whom 4470 had been diagnosed with schizophrenia. People with schizophrenia were more likely to live in a lower-income neighborhood, to have other psychiatric and chronic medical conditions, and to have had an emergency department (ED) visit for interpersonal violence in the two years before their pregnancy.

Overall, 3.1% of people with schizophrenia had an ED visit for interpersonal violence during pregnancy and the first year postpartum, versus 0.4% of those without schizophrenia.

Among study participants screened and did not disclose interpersonal violence in pregnancy, schizophrenia was associated with a sixfold increase in the risk of experiencing an ED visit for interpersonal violence in both pregnancy and postpartum.

Dr. Simone Vigod, head of psychiatry at Women’s College Hospital and a professor at the Temerty Faculty of Medicine, University of Toronto, with coauthors, said, “The study suggests that routine violence screening in antenatal care settings is an important opportunity for intervention to prevent severe physical, psychological and social harm to these patients and their children.”

Journal Reference:

  1. Kelly Leslie, Lucy C. Barker et al. Risk of interpersonal violence during and after pregnancy among people with schizophrenia: a population-based cohort study. Canadian Medical Association Journal. DOI: 10.1503/cmaj.220689

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