Determinants of victimization in patients with severe mental illness: Results from a nation-wide cross-sectional survey in the Netherlands

We aimed to examine determinants of criminal victimization (i.e. both personal and property crime victimization) in outpatients with severe mental illness.Data was collected using a multisite epidemiological survey including a random sample of 956 adult outpatients with SMI. Data on 12-month victimization prevalence and frequency were obtained using the victimization scale of the Dutch Crime and Victimization Survey. Demographic characteristics, clinical diagnosis, psychosocial functioning, drug use and alcohol abuse over the past 12 months, co-morbid PTSD diagnosis, physical abuse, physical neglect and sexual abuse in childhood, perpetration of violence over the past 12-months, and anger disposition were assessed as determinants. Univariable and multivariable hurdle regression analyses were conducted to test associations of the potential determinants with victimization prevalence and frequency. We found that different sets of demographic and clinical characteristics were associated with personal and property crime victimization. Clinical characteristics were more pronounced regarding personal crime victimization. In the multivariable model, presence of psychotic disorder, drug use, childhood physical and sexual abuse, and recent violent perpetration were associated with the 12-month prevalence orfrequency rate of personal crime victimization. Native Dutch and divorced patients were more at risk as well. Next to this being employed, poor social functioning, having perpetrated a violent crime, as well as alcohol abuse and recent drug use were all significantly related to property crime prevalence or frequency rate in the multivariable model. Clinicians should be aware of the high risk of victimization among their patients with severe mental illness. Symptom reduction and enhancing psychosocial functioning is important in preventing 4victimization. Perpetrators of violence especially need attention, since they are likely to be both perpetrators as well as victims.