Evidence map›Paper›PMID 41863377›Full record

SynthesisSchizophrenia bulletin2026

Systematic review of stranger homicides by psychotic individuals.

Jenna Räsänen, Ilkka Ojansuu, Jari Tiihonen, Johannes Lieslehto, Markku Lähteenvuo

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jenna RäsänenDepartment of Forensic Psychiatry, University of Eastern Finland Niuvanniemi Hospital, Kuopio, Finland.
Ilkka OjansuuDepartment of Forensic Psychiatry, University of Eastern Finland Niuvanniemi Hospital, Kuopio, Finland.
Jari TiihonenDepartment of Forensic Psychiatry, University of Eastern Finland Niuvanniemi Hospital, Kuopio, Finland.
Johannes LieslehtoDepartment of Forensic Psychiatry, University of Eastern Finland Niuvanniemi Hospital, Kuopio, Finland.
Markku LähteenvuoDepartment of Forensic Psychiatry, University of Eastern Finland Niuvanniemi Hospital, Kuopio, Finland.ORCID 0000-0002-7244-145X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and hypothesisIndividuals with psychosis have an increased risk of committing and being victims of violence. There are frequent media reports of psychotic individuals assaulting strangers, which may cause fear and stigmatization among the general public. We hypothesize that homicides targeting strangers by psychotic individuals are rare. STUDY

designSystematic review and meta-analysis to assess what percentage of homicide offenders suffering from psychosis target strangers. Medline database was searched with search term 'psychosis OR schizophrenia AND homicide' from inception to 10/2024. Articles published in peer-reviewed journals, written in English, and reporting the total number of homicide offenders with psychosis (ICD-10: F20, F22, F25, F30-F31, F32.3, F29) and stranger victims were included. PRISMA guidelines were followed. Studies with inadequate data were excluded. A random-effects meta-analysis using meta and metafor packages in R version 4.4.2 was conducted using the restricted maximum-likelihood (REML) method to account for variability across studies. The primary outcome was the pooled rate of stranger homicides among individuals with psychosis who committed a homicide, expressed as a proportion with 95% confidence intervals (CIs). STUDY

resultsThirteen studies were included, comprising a total of 1,438 perpetrators who had killed 177 strangers. Meta-analysis of these studies indicates that 12.7% (95% CI: 7.85-17.56 and heterogeneity I2 89.49%) of the homicides by psychotic individuals are targeted at strangers. Male gender explained 26.9% of between-study variance (P-value<0.05).

conclusionsAlthough still rare, the percentage of homicides committed by psychotic individuals and targeted at strangers is higher than previously reported.

Indexed as

Crime VictimsCriminalsHomicidePsychotic DisordersSchizophreniaHumansMalepsychosisschizophreniaviolence

Identifiers

PMID41863377
PMCPMC13005101

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.