Comprehensive Approach to Psychiatry 1 Bernardo Carpiniello Antonio Vita Claudio Mencacci Editors Violence and Mental Disorders Comprehensive Approach to Psychiatry 1 Series Editors Bernardo Carpiniello Department of Medical Science and Public Health University of Cagliari Cagliari, Italy Antonio Vita Department of Clinical and Experimental Science University of Brescia Brescia, Italy Claudio Mencacci Department of Neuroscience Luigi Sacco Hospital Milano, Italy [email protected] This book series will cover a broad range of topics with each volume providing an up-to-date overview of subject matters of particular interest for psychiatrists and other professionals in the field of mental health, through a comprehensive approach, including clinical, therapeutical, forensic and psychosocial points of view. The topics addressed will be selected in collaboration with the Italian Society of Psychiatry. The book series is aimed at psychiatrists, psychotherapists, psychologists, social workers, nurses, psychiatric rehabilitation technicians, students and researchers. More information about this series at http://www.springer.com/series/16231 [email protected] Bernardo Carpiniello Antonio Vita • Claudio Mencacci Editors Violence and Mental Disorders [email protected] Editors Bernardo Carpiniello Antonio Vita Department of Medical Science Department of Clinical and Experimental and Public Health Science University of Cagliari University of Brescia Cagliari Brescia Italy Italy Claudio Mencacci Department of Neuroscience Luigi Sacco Hospital Milano Italy ISSN 2524-8405 ISSN 2524-8413 (electronic) Comprehensive Approach to Psychiatry 1 ISBN 978-3-030-33187-0 ISBN 978-3-030-33188-7 (eBook) https://doi.org/10.1007/978-3-030-33188-7 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland [email protected] Foreword This volume on Violence and Mental Disorders is the first in a series entitled Comprehensive Approach to Psychiatry edited by the Italian Psychiatric Association (Società Italiana di Psichiatria, SIP) in collaboration with Springer. One of the main goals of our Association is to promote scientific knowledge at an international level based on the contribution provided by Italian Psychiatry. The identification of vio- lence as an opening issue for the series is not a fortuitous choice. Indeed, although mental disorders contribute to overall societal violence to a limited extent, this involvement unfortunately continues to be associated with a disproportionate degree of social alarm. Violent behaviors are frequently associated with mental disorder, eliciting fear among both the general population and healthcare professionals. In all honesty we should acknowledge how mental disorder and violence are still today perceived as being closely connected, leading to an unbearably heavy stigma for both patients and psychiatrists. A major step forward introduced in 1978 with the Italian Psychiatric Reform related to removal of the wording “danger to oneself or to others …” from the criteria for coercive psychiatric treatment, and the abolition of Psychiatric Hospitals, a process of deinstitutionalization which recently con- cluded with the dismantling of the Judicial Psychiatric Hospitals. Indeed, the highly debated Law 81/2014 saw Italy resolutely opt to go beyond the administration of large forensic institutes, replacing them with a network of small residential facilities known as “REMS” (Residences for the execution of safety measures), now man- aged by the National Health Service. On these grounds, the issue of the social dan- gerousness of patients with a mental disorder has been the focus of recent debate in Italy, investigating the appropriateness of refocusing the issue on the treatability of the disorder in those who commit a criminal act. To contribute towards reducing the stigma that accompanies mental disorder, for years our Association has been solicit- ing the Italian Judicial System to abolish the inclusion of “social dangerousness” from mandatory psychiatric assessments for patients who commit crimes. Indeed, the Association advocates that psychiatrists should be asked to evaluate solely the need for care of the subject, suggesting the potential outcomes of the disorder in relation to treatment prescribed, leaving the task of evaluating the social dangerous- ness of the perpetrator up to the legal system, based on the same criteria routinely adopted to define as socially dangerous a criminal with no history of mental disor- ders. We trust that this volume edited by Carpiniello, Vita, and Mencacci, through a comprehensive overview of the complicated issue of violence in mental disorders v [email protected] vi Foreword and input from a series of leading international experts in the field, may provide a significant contribution towards a better understanding of the multifaceted nature of this intricate problem. Enrico Zanalda President Italian Psychiatric Association Massimo di Giannantonio President Elected Italian Psychiatric Association [email protected] Contents Part I General Aspects 1 Violence as a Social, Clinical, and Forensic Problem . 3 Bernardo Carpiniello, Claudio Mencacci, and Antonio Vita 2 Neurobiology of Violence . 25 Mirko Manchia, Linda Booij, Federica Pinna, Janice Wong, Florian Zepf, and Stefano Comai 3 Epidemiology and Risk Factors for Violence in People with Mental Disorders . 49 Daniel Whiting and Seena Fazel Part II Risk Factors, Phenomenology and Characteristics of Violence in Mental Disorders 4 Violence in Major Mental Disorders �������������������������������������������������������� 65 Mario Amore, Andrea Aguglia, Francesca Santi, and Gianluca Serafini 5 Psychopathy, Personality Disorders, and Violence . 81 Stefano Ferracuti, Gabriele Mandarelli, and Antonio Del Casale 6 Substance-Use Disorders and Violence ���������������������������������������������������� 95 Fabrizio Schifano, Caroline Zangani, Stefania Chiappini, Amira Guirguis, Stefania Bonaccorso, and John M. Corkery 7 Posttraumatic Stress Disorder, Intimate Partner Violence, and Trauma-Informed Intervention ���������������������������������������� 115 Ohad Gilbar, Katherine E. Gnall, Hannah E. Cole, and Casey T. Taft 8 Major Neurocognitive Disorders and Violence . 135 Tracy Wharton and Daniel Paulson vii [email protected] viii Contents Part III The Contexts of Violence 9 Studying Patients with Severe Mental Disorders Who Act Violently: Italian and European Projects �������������������������������� 155 Giovanni de Girolamo, Giorgio Bianconi, Maria Elena Boero, Giuseppe Carrà, Massimo Clerici, Maria Teresa Ferla, Gian Marco Giobbio, Giovanni Battista Tura, Antonio Vita, and Clarissa Ferrari 10 Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: Systematic Review and Meta-Analysis—A 2019 Update �������������������������������������������������������� 181 Ester di Giacomo, Laura Iozzino, Clarissa Ferrari, Cosmo Strozza, Matthew Large, Olav Nielssen, and Giovanni de Girolamo 11 Violence and Mental Disorders in Jails ���������������������������������������������������� 203 Ester di Giacomo and Massimo Clerici 12 Violent Behavior in Forensic Residential Facilities: The Italian Experience After the Closure of Forensic Psychiatric Hospitals . 211 Enrico Zanalda, David De Cori, Grazia Ala, Alessandro Jaretti Sodano, and Marco Zuffranieri Part IV Prevention and Management of Violence in Mental Health 13 Violence Risk Assessment in Mental Health �������������������������������������������� 231 Liliana Lorettu, Alessandra M. A. Nivoli, Paolo Milia, and Giancarlo Nivoli 14 Psychopharmacology of Violent Behavior Among People with Severe Mental Disorders . 253 Leslie Citrome and Jan Volavka 15 Non-pharmacological Approaches to Violence Among People with Severe Mental Disorders . 269 Antonio Vita, Valentina Stanga, Anna Ceraso, Giacomo Deste, and Stefano Barlati [email protected] Part I General Aspects [email protected] Violence as a Social, Clinical, and Forensic Problem 1 Bernardo Carpiniello, Claudio Mencacci, and Antonio Vita 1.1 Violence as a Social Problem 1.1.1 Violence as a Social and Public Health Problem In 1996, the 9th World Health Assembly adopted Resolution WHA49.25, “noting