Moderation analysis.

Purpose
The overall crime rate among individuals with severe mental illnesses is similar to that of the general population, although some studies suggest a higher risk of violent crime among this group. Empirical research on factors associated with violent crime among individuals with mental illnesses in East Asia remains limited.
Methods
This study examined 648 offenders referred for forensic psychiatric evaluation by the criminal justice system to explore the relationship between severe mental illness, substance-related and addictive disorders, and violent crime. Demographic, clinical, forensic, and both static and dynamic factors were analyzed using bivariate analysis and multivariate logistic regression. We also tested the moderating effects of gender, history of violent crime, poor treatment adherence, and comorbid substance-related and addictive disorders on the association between severe mental illness and violent crime.
Results
The results showed that violent offenders were more likely to be male and to have never undergone a psychiatric evaluation prior to the offense, compared to non-violent offenders. Severe mental illness, substance-related and addictive disorders, single status, unemployment, and poor treatment adherence were not significantly associated with violent crime. Furthermore, gender, poor treatment adherence, a history of violent crime, and comorbid substance-related and addictive disorders did not significantly moderate the relationship between severe mental illness and violent crime.
Conclusion
These findings emphasize that individuals with severe mental illness should not be automatically linked to violent offending. A comprehensive evaluation of offenders with severe mental illness is crucial, alongside a deeper understanding of their treatment and reintegration needs.

研究目的
严重精神疾病（severe mental illnesses）患者的整体犯罪率与普通人群相近，尽管部分研究提示该群体暴力犯罪风险更高。但目前针对东亚地区精神疾病患者暴力犯罪相关影响因素的实证研究仍较为有限。

研究方法
本研究纳入648名由刑事司法系统委托进行司法精神鉴定（forensic psychiatric evaluation）的罪犯，旨在探讨严重精神疾病、物质相关及成瘾障碍（substance-related and addictive disorders）与暴力犯罪之间的关联。研究采用双变量分析（bivariate analysis）与多因素logistic回归（multivariate logistic regression），对人口学、临床学、法医学相关因素及静态、动态风险因素进行分析。此外，本研究还检验了性别、暴力犯罪史、治疗依从性差以及共病（comorbid）物质相关及成瘾障碍，在严重精神疾病与暴力犯罪关联中的调节效应（moderating effects）。

研究结果
结果显示，相较于非暴力犯罪者，暴力犯罪者更大概率为男性，且在作案前从未接受过精神评估。严重精神疾病、物质相关及成瘾障碍、单身状态、失业及治疗依从性差，均与暴力犯罪无显著关联。进一步分析表明，性别、治疗依从性差、暴力犯罪史以及共病物质相关及成瘾障碍，也未对严重精神疾病与暴力犯罪的关联产生显著调节效应。

研究结论
本研究结果提示，不应将严重精神疾病患者与暴力犯罪直接挂钩。对严重精神疾病罪犯开展全面评估，并深入了解其治疗与社会复归需求，具有重要意义。