While the relationship between psychiatric disorders and violent behavior has been studied in the USA and Western Europe, there has been no systematic research in this area in the post communist countries. In our previous studies, we examined a) prevalence and characteristics of violence among psychiatric patients, b) trends in violent behavior among patient suffering from schizophrenia and c) their victimization

In 1-year prospective study in 140-bed university-based psychiatric clinic prevalence of violence among all hospitalized patients was 5%. Patients with organic disorders exhibited most violence (14%), followed by patients suffering from schizophrenia (7%).

While number of reports confirm rapidly growing rate of mentally disordered offenders, this does not apply to the Czech Republic.

In our first study (1) we analyzed prevalence of violence among schizophrenic patients in the years 1949, 1969, 1989, and 2000 in Prague (Czech Republic). Overall, violence was 41.8% for men and 32.7% for women. There was no increase in violence in schizophrenic patients between 1949 and 1989, and only a marginally higher prevalence of violence was reported in the 2000 sample. Family members and medical staff are the most frequent victims of violence.

In the second study, we have not found significant increase in admissions to a large forensic psychiatric facility between 2002 and 2007. Further, number of court ordered forensic treatments between 1991 and 2007 for o psychiatric and sex offences remained unchanged. However there was a steep increase (162%) in number of treatments imposed for abusing illicit drugs.

We have hypothesized that the high rate of adult psychiatric hospitalizations has protected patients with serious mental disorders from engaging in criminal behavior. It is necessary to identify the subgroup of patients for whom longer inpatient care is of benefit. In the Czech Republic, this process is important in the sense that there is a need to promote shorter hospitalizations and high quality community care for the vast majority of patients.

It is becoming increasingly clear that people with schizophrenia are more often victims than perpetrators of violence.

In our current study in psychiatric inpatients 39% female and 30% male schizophrenic patients were victimized during previous 6 months (using MacArthur Questionnaire) and and 7% men and 14% women suffered also from PTSD (using SCID module)

The high rate of PTSD in persons with schizophrenia has important clinical implications. Once PTSD will be diagnosed another therapeutic procedures (e.g. cognitive restructuring, exposure therapy) could be added to antipsychotic therapy. Effective treatment for those problems could improve both physical and mental health functioning.