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Background: The management of mentally ill offenders in the community is one of the great challenges imposed on community psychiatry. Aim: The aim of this study was to analyze the association between sociodemographic, clinical, and psychosocial factors and violent behavior in a sample of outpatients with severe mental disorders. Method: This was a prospective cohort study with a baseline cross-sectional design used to provide a detailed analysis of patients’ profiles, followed by a longitudinal design to measure aggressive and violent behavior during a 1-year follow-up. Patients with severe mental disorders, with or without a history of violence, were enrolled in four Italian Departments of Mental Health and underwent a comprehensive multidimensional assessment. Results: The sample included 247 outpatients, for a total of 126 cases and 121 controls. Compared to controls, patients with a history of violence had a greater frequency of lifetime domestic violence, a greater lifetime propensity to misuse substances, and a higher number of compulsory admissions. The forthnightly monitoring during the 1-year follow-up did show statistically significant differences in aggressive and violent behavior rates between the two groups. Verbal aggression was significantly associated with aggression against objects and physical aggression. Moreover, outpatients with an history of violence showed statistically significant higher MOAS scores compared to both residential patients with an history of violence, assessed in the first wave of this project, and all controls. Conclusions: Patients with a history of violence had specific characteristics and showed a greater occurrence of additional community violence during a 1-year observation period. Our results may assist clinicians in implementing standardized methods of patient assessment and violence monitoring in outpatient mental health services and may prompt improved collaboration between different community services. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore the prevalence of cardiovascular disease (CVD) risk factors in people with severe mental illness (SMI), estimating its weight on related risks in Southern Europe, an area with distinct dietary traditions. People with SMI may be more likely than general population to have high prevalence of risk factors for CVDs, due to several reasons, including poor health behaviours and psychopharmacological medications. Method A cross-sectional study has been conducted, comparing inpatients with and without SMI. Univariate and multivariate analyses and logistic regression models have been carried out, exploring the effect of SMI on the prevalence of CVD risk factors. Results Although obesity and hypertriglyceridemia were more prevalent among people with SMI, controlling for relevant confounders in multivariate analyses we could not detect any significant difference. Conclusions People with SMI may not necessarily have higher CVD risk, as compared with general population. Mediterranean healthy dietary habits, universal health coverage, families providing strong support, all are possible explanations for our findings. Further research is needed, exploring different mechanisms, with more detailed biological and genetics measures. [ABSTRACT FROM AUTHOR]