Violent Men: Investigating Mental Disorder, Substance Use and PTSD

This study considered the relationship between mental disorder, substance use, violence, trauma and posttraumatic stress disorder (PTSD) problems in a sample of male patients within a mental health directorate of a high secure hospital. All patients admitted to the service in the five years prior to March 2010 were considered for the study. A total of fifty-two patients were approached to participate in the study, of which 32 consented, representing 25% of all patients in the service. Multiple methods of assessment incorporating both qualitative and quantitative approaches were used to gather information on mental health, substance misuse, violence, and trauma and posttraumatic stress disorder problems. A full data set was completed for twenty-eight patients and a partial data set for a further four. The sample was found to have a considerable history of poly-drug use, previous contact with psychiatric services, and convictions for serious violence. Differences were found between patients with a paranoid schizophrenia and schizophrenia diagnosis in relation to, types of drugs used and dependency to drugs, with drug preference and sensitivity to drug effects being found to differ between the two groups. A relationship was also found between type, level, frequency and dependency to a number of drugs and frequency and type of violence convictions which differed between diagnostic groups. Likewise, previous psychiatric and custodial history was also found to be associated with substance use and violence convictions. The sample also had an extensive trauma history and while rates of PTSD were low, the prevalence of sub-clinical PTSD symptoms was found to be extensive. PTSD problems were found to be associated with mental health and substance misuse problems, and some instances of violence. These findings suggest that PTSD related difficulties need to be considered when looking at substance misuse in people with a severe mental health diagnosis.