32 Soc Psychiat Epidemiol (2011) 46:29–34 Table 2 Twelve-month rate of violent victimisation in Stockholm among 390 psychiatric patients and 1,170 gender- and age-matched controls in Stockholm Percent (95% CI) Cases Controls Males (n = 187) Females (n = 203) Total (n = 390) Males (n = 561) Females (n = 609) Total (n = 1,170) Visible injury 13.5% (9.0–19.1) 15.5% (10.6–21.0) Medical attention 8.5% (5.0–13.5) 11.8% (7.7–17.0) Any victimisation 19.2% (13.9–25.6) 23.1% (17.5–29.6) 14.5% (11.3–18.5) 3.5% (2.2–5.5) 10.2% (7.2–13.4) 2.1% (1.1–3.7) 20.0% (16.1–24.3) 4.9% (3.2–6.9) 2.3% (1.3–3.8) 0.7% (0.2–1.7) 2.8% (1.6–4.4) 2.9% (2.0–4.0) 1.3% (0.7–2.1) 3.8% (2.8–5.0) Table 3 Crude odds ratio for 12-month rate of victimisation among 390 psychiatric patients versus 1,170 gender and age-matched controls in Stockholm Males OR (95% CI), P value Females OR (95% CI), P value Total OR (95% CI), P value Visible injury Medical attention Any victimisation 4.2 (2.2–8.1), P \ 0.001 4.3 (1.9–11.9), P \ 0.001 4.7 (2.6–8.3), P \ 0.001 Cases and controls were tested (P value) using Chi-square test (Table 3). The latter were more at risk of victimisation that required medical attention, with an OR of 20.3 (CI 6.8– 81.1). No such difference was noted among male patients. Discussion Victimisation The ﬁrst main ﬁnding is that 20% of general psychiatric patients in Stockholm had been victimised within 1 year prior to interview. A UK study found that 16% of urban residents with a psychotic disorder had been victimised during the preceding 12 months [25] and 23% 2 years after inclusion [5]. A study from the UK, France and Germany on people with schizophrenia found that 10% had been violently victimised during a period of 2.5 years [17]. A Finnish study on patients with schizophrenia, interviewed 3 years after discharge, shows an even lower rate of being victim of a violent crime, 5.6% [12]. In contrast, a study on severely mentally ill in-patients from inner-city areas of London, reports a considerably higher rate, 53%, of violent victimisation 6 months prior inclusion [10]. These shifting rates may all be attributed to different methodology and deﬁnition of victimisation but it is likely that socio-geo- graphic factors, co-morbidity and, possibly, severity of the psychiatric disorder also play a role. The second main ﬁnding, that psychiatric patients were six times more at risk of victimisation than the general population, is compatible with the results of four other controlled studies from New Zealand and the USA [4, 19, 20, 23]. Three of these studies report a 2–4 times higher risk [4, 19, 20], while one shows an 11-fold increase of risk, and as in our study, the relative risk increases with the 123 7.7 (3.8–15.9), P \ 0.001 20.3 (6.8–81.1), P \ 0.001 10.5 (5.7–19.9), P \ 0.001 5.7 (3.6–9.2), P \ 0.001 8.8 (4.7–17.3), P \ 0.001 6.4 (4.2–9.7), P \ 0.001 severity of the violence [23]. However, in order to assess international comparisons of relative rates of victimisation, it is necessary to consider the variation of the base rate of victimisation within the general population of each coun- try. According to an international multi-centre study, the 12-month rate of violent victimisation in the general pop- ulation is 3.6% in Sweden, 4.6% in Finland, 4.8% in the UK, 6.0% in New Zealand and 7.7% in the USA [24]. Thus, should the rates of victimisation among psychiatric patients follow this pattern, all countries will report similar relative rates, suggesting that the mentally disordered are equally disadvantaged in all the countries concerned. The literature, including this study, lends some support to this view. There is less international consensus concerning the third main ﬁnding that female patients are especially at risk of victimisation, and that this risk is most prominent for more severe types of violence. Some studies report that male patients are more often violently victimised [12, 19, 25], others claim that there are no gender differences [5, 7, 8, 17], while some ﬁnd female patients to be more often victimised [1, 2]. The only other study that compares odds ratio with a gender perspective is a retrospective study from USA on 936 individuals with severe mental illness [22]. The results show that the relative risk for completed violent victimisation was 9 for the males and 19 for the females, compared to matched controls. Limitations Recall bias is a potential problem in a study of this kind, although self-report is considered a better measurement of victimisation among psychiatric patients compared to e.g. police-records or other records [13]. Yet, the relative rate