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The predictive value of risk categorization in schizophrenia

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Large, Matthew M., Ryan, Christopher J., Singh, Swaran P., Paton, Michael B. and Nielssen, Olav B. (2011) The predictive value of risk categorization in schizophrenia. Harvard Review of Psychiatry, Vol.19 (No.1). pp. 25-33. doi:10.3109/10673229.2011.549770 ISSN 1067-3229.

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Official URL: http://dx.doi.org/10.3109/10673229.2011.549770

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Abstract

Background: Risk assessment is increasingly used to inform decisions regarding the psychiatric treatment of patients with schizophrenia and other serious mental disorders. Aims: To examine the theoretical limits of risk assessment and risk categorization as applied to a range of harms known to be associated with schizophrenia. Methods: Using known rates of suicide, homicide, self-harm, and violence in schizophrenia, a hypothetical tool with an unrealistically high level of accuracy was used to calculate the proportion of true- and false-positive risk categorizations. Results: Risk categorization incorrectly classified a large proportion of patients as being at high risk of violence toward themselves and others. Conclusion: Risk assessment and categorization have severe limitations. A large proportion of patients classified as being at high risk will not, in fact, cause or suffer any harm. Unintended consequences of inaccurate risk categorization include unwarranted detention for some patients, failure to treat others, misallocation of scarce health resources, and the stigma arising from patients' being labeled as dangerous. (HARV REV PSYCHIATRY 2011;19:25-33.)

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Harvard Review of Psychiatry
Publisher: Informa Healthcare
ISSN: 1067-3229
Official Date: January 2011
Dates:
DateEvent
January 2011Published
Volume: Vol.19
Number: No.1
Page Range: pp. 25-33
DOI: 10.3109/10673229.2011.549770
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

Data sourced from Thomson Reuters' Web of Knowledge

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