Gender differences in psychiatric morbidity and violent behaviour among a household population in Great Britain.

BACKGROUND: Men are more violent than women. It is unclear whether psychiatric morbidity contributes to this gender difference in the general population. This study examined gender differences in psychiatric diagnosis and violent behaviour to test whether risk from psychiatric morbidity accounted for gender differences in violent behaviour; whether violent males were more vulnerable to risk from psychiatric morbidity; and, whether violent women surmounted a higher threshold of risk from psychiatric morbidity.

METHODS: Cross-sectional random sample of 8,397 household residents in Great Britain was assessed using structured questionnaires to measure violent behaviour and psychiatric morbidity. Weighted multilevel regression models were used to test hypotheses, adjusting for demographic factors, psychiatric comorbidity and area effects of violence.

RESULTS: Men were more likely to report violence than women and were exposed to greater risks from substance dependence, Antisocial Personality Disorder (ASPD) and hazardous drinking. Women were exposed to greater risks from affective/anxiety disorders. Psychiatric morbidity explained 22% of the gender difference in violence. Violent men were less vulnerable to risk from any Personality Disorder (PD), in particular ASPD, than violent women. Violent women reported a higher etiological threshold for affective/anxiety disorders and any PD; violent men higher threshold for alcohol dependence and hazardous drinking.

CONCLUSIONS: Psychiatric morbidity has moderate impact on higher levels of violence among men. Antisocial Personality Disorder poses a greater risk for violence among women than men. Affective/anxiety disorders and any PD are more severe conditions among violent women; alcohol dependence and hazardous drinking are more severe among violent men, confirming the "Threshold of Risk" hypothesis.