Assault Victims With Severe Mental Illness At Risk of Relapse

Investigators sought to assess the effect of physical assault on risk of hospitalization in individuals with severe mental illness.

People previously hospitalized for severe mental illness are 3 times more likely to be rehospitalized within 6 months after an assault compared with their non-assaulted counterparts, according to the results of a cohort study published in Annals of General Psychiatry.

Individuals with severe mental illness (SMI) are more likely to be subject to violent or nonviolent victimization. This victimization may affect the time course of SMI, risk of violence, and rehospitalization. To explore the association further, a team of researchers conducted a nationwide, register-based retrospective cohort study in the Czech Republic.

The researchers used data from 2 health registers maintained by the Czech Institute of Health Information and Statistics. They identified 254 individuals with a history of SMI hospitalization who had been assaulted.

“Individuals with SMI who experienced an assault-related hospitalization had an approximately three times higher risk to be hospitalized for SMI within the subsequent 6 months than their non-assaulted counterparts,” the researchers found. “In general, the risk of SMI relapse and rehospitalization is increased by comorbid drug use disorders.” The association was not due to the confounding effects of drug use, they added.

The analysis did not include incidents that did not require hospitalization; therefore, its results may not generalize to a broader population of victimized individuals with SMI. The researchers also lacked information on diagnoses, outpatient care, and socioeconomic status.

Applying their findings, the researchers advise, “soon after a person with SMI is physically assaulted, there should be an evaluation by a mental health professional and close follow-up. Medical and psychological support should be provided as needed. After the patient is victimized, care givers should be particularly vigilant regarding the potential for drug and alcohol abuse. This approach could potentially improve the quality of life of individuals with SMI as well as reduce societal and rehospitalization costs, particularly in the 6-month period following an assault.”


Mlada K, Formanek T, Vevera J, Latalova K, Winkler P, Volavka J. Serious physical assault and subsequent risk for rehospitalization in individuals with severe mental illness: a nationwide, register-based retrospective cohort study. Ann Gen Psychiatry. Published online September 18, 2021. doi:10.1186/s12991-021-00358-y