Research Interests

Epidemiology of mental illness and violent crime, risk factors for violent crime in mental illness, mental disorders in homicide and sexual offenders, risk factors for repeat offending.
Funded by the Wellcome Trust

Clinical prediction rules and risk assessment for suicide and violence in mental illness, violence risk assessment in prisoners and community offenders. Funded by the Wellcome Trust

Mental health of prisoners, suicidal behaviour in prisoners, risk factors for self-harm and suicide in prisoners, adverse outcomes in recently released prisoners.
Funded by the Wellcome Trust and NIHR

Suicide risk assessment in prisoners. Funded by HTA Programme

Health needs of older prisoners. Funded by NIHR

Capacity and competence including fitness to plead and stand trial, capacity to complete advance directives, capacity/competence to consent to treatment. Previously funded by NIHR

Recent media interest in research

Violence and mental illness: five minutes with Seena Fazel. BMJ.

Common nerve pain drug linked to suicidal behavior, overdose. Reuters.

Prison suicide: BBC website

Violence risk assessment tool in severe mental illness – ‘a tremendous step forward’: American Council on Science and Health

‘A single concussion’: New York Times

Head injury in children and adolescents: PLoS Science AMA

Risk of violent reoffending in prisoners with mental illness: Guardian

Antidepressants and risk of violent crimes: Guardian

“Schizophrenia associated with increased rates of violence and suicide”: BMJ News

“Mental Illness Can Shorten Lives More Than Chain-Smoking”: National Public Radio

“Medications Cut Violence Among Mentally Ill in Study”: Wall Street Journal

‘Coin-toss justice’: New Scientist

The Drugs Don’t Work? (book review): PLoS Medicine Community Blog

“Brain injury survivors three times more likely to die prematurely”
The GuardianReuters

“Self-harm ‘four times more likely’ in female prisoners”: BBC News

Publications

Latest Publications

Violence and mental illness

Whiting D, Lichtenstein P,  Fazel S (2021). Violence and mental disorders: a structured review of associations by individual diagnoses, risk factors, and risk assessment. Lancet Psychiatry 8: 150-161. 

Sariaslan A, Arseneault L, Larsson H, Lichtenstein P, Fazel S. (2020) Risk of subjection to violence and perpetration of violence in persons with psychiatric disorders in Sweden. JAMA Psychiatry 77: 359-367;  doi:10.1001/jamapsychiatry.2019.4275

Senior M, Fazel S, Tsiachristas A. (2020). The economic impact of violence perpetration in severe mental illness: a retrospective, prevalence-based analysis in England and Wales. Lancet Public Health 5 (2): e99-e106

Yu R, Nevado-Holgado AJ, Molero Y, D’Onofrio BM, Larsson H, Howard LM, Fazel S. (2019). Mental disorders and intimate partner violence perpetrated by men towards women: A Swedish population-based longitudinal study. PLoS Medicine; https://doi.org/10.1371/journal.pmed.1002995

Fazel S, Smith EN, Chang Z, Geddes JR. (2018) Risk factors for interpersonal violence: an umbrella review of meta-analyses. British Journal of Psychiatry 213 (4), 609-614.

Yu R et al. (2017). Depression and violence in adolescence and young adults: findings from three longitudinal cohorts. Journal of the American Academy of Child & Adolescent Psychiatry 56 (8), 652-658.

Sariaslan A, Larsson H, Fazel S. (2016) Genetic and environmental. determinants of violence risk in psychotic disorders: a multivariate quantitative genetic study of 1.8 million Swedish twins and siblings. Molecular Psychiatry; 21: 1251-1256.

Sariaslan A, Lichtenstein P, Larsson H, Fazel S. (2016) Triggers for violent criminality in patients with psychotic disorders. JAMA Psychiatry; 73: 796-803.

Fazel S, Wolf A, Chang Z, Larson H, Goodwin G, Lichtenstein P. (2015) Depression and violent crime: Swedish population study. Lancet Psychiatry 2: 224-232
http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)00128-X/abstract

Fazel S, Wolf A, Palm C, Lichtenstein P. (2014) Violent crime, suicide, and premature mortality in patients with schizophrenia and related disorders: a 38-year total population study in Sweden. Lancet Psychiatry 1: 44-54.
http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)70223-8/abstract

Prisoner health

Beaudry G, Zhong S, Whiting D, Javid B, Frater J, Fazel S. (2020) Managing outbreaks of highly contagious diseases in prisons: a systematic review. BMJ Global Health 5 (11): e003201

Baranyi G, Scholl C, Fazel S, Patel V, Priebe S, Mundt AP. (2019) Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies. Lancet Global Health 7 (4), e461-e471.

Fazel S. (2018). Editorial: Synthesizing the evidence on prisoner health – Taking Stock and Moving Forward. American Journal of Epidemiology 187:1137–1139 [editorial]

Baranyi G et al. (2018)  Prevalence of posttraumatic stress disorder in prisoners. Epidemiologic Reviews, https://doi.org/10.1093/epirev/mxx015

Mundt A et al. (2018) Substance use during imprisonment in low- and middle-income countries. Epidemiologic Reviews, https://doi.org/10.1093/epirev/mxx016

Fazel S, Yoon IA, Hayes AJ (2017). Substance use disorders in prisoners: an updated systematic review and meta-regression analysis in recently incarcerated men and women. Addiction 112 (10): 1725-1739. DOI: 10.1111/add.13877

Yoon I, Slade K, Fazel S. (2017) Outcomes of psychological therapies for prisoners with mental health problems: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology 85: 783-802.

Fazel S, Hayes A, Bartellas K, Trestman R. (2016) Mental health of prisoners: prevalence, adverse outcomes, and interventions. Lancet Psychiatry 3: 871-881.

Fazel S, Seewald K. (2012) Severe mental illness in 33 588 prisoners worldwide: systematic review and meta-regression analysis. Br J Psychiatry 200: 364-73.

Fazel S, Baillargeon J. (2011) The health of prisoners. Lancet 377: 956-965.

Released prisoners – mortality and reoffending risks

Chang Z, Lichtenstein P, Långström N, Larsson H, Fazel S (2016) Association between prescription of major psychotropic medications and violent reoffending after prison release. JAMA 316(17): 1798-1807.

Sariaslan A, Larsson H, Lichtenstein P, Fazel S. (2017) Neighbourhood influences on violent reoffending risk in released prisoners diagnosed with psychotic disorders. Schizophrenia Bulletin 43: 1011-1020.

Chang Z, Larsson H, Lichtenstein P, Fazel S. (2015) Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden, Lancet Psychiatry 2: 891-900.

Yukhnenko D, Sridhar S, Fazel S. (2019) A systematic review of criminal recidivism rates worldwide: 3-year update. Wellcome Open Research: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743246.3/

Prisoner self harm and suicide risk

Zhong S, Senior M, Yu R, Perry AE, Hawton K, Shaw J, Fazel S. Risk factors for suicide in prisons: an updated systematic review and meta-analysis. Lancet Public Health 2021; 6 (3): e164-e174

Favril, L, Yu R, Hawton K, Fazel S. Risk factors for self-harm in prison: a systematic review and meta-analysis. Lancet Psychiatry 2020; 7 (8): 682-691.

Domenico FD et al. (2020) 1324 prison suicides in 10 countries in South America: incidence, relative risks, and ecological factors. Social Psychiatry and Psychiatric Epidemiology 56 (2): 315-323.

Fazel S, Ramesh T, Hawton K. (2017) Suicide in prisons: an international study of prevalence and contributory factors. Lancet Psychiatry 4: 946–952.

Marzano L, Hawton K, Rivlin A, Smith EN, Piper M, Fazel S. (2016) Prevention of suicidal behaviour in prisons. Crisis 37: 323-334.

Hawton K, Linsell L, Adeniji T, Sariaslan A, Fazel S (2014) Self-harm in prisons in England and Wales: an epidemiological study of prevalence, risk factors, clustering, and subsequent suicide. Lancet 383: 1147-54.

Violence risk assessment

Fazel S. (2019). The Scientific Validity of Current Approaches to Violence and Criminal Risk Assessment. In: Predictive Sentencing: Normative and Empirical Perspectives, 197 (London: Bloomsbury).

Fazel S, A Wolf, M Vazquez-Montes, TR Fanshawe. (2019) Prediction of violent reoffending in prisoners and individuals on probation: a Dutch validation study (OxRec). Scientific Reports 9 (1), 841.

Ramesh T et al. (2018) Use of risk assessment instruments to predict violence in forensic psychiatric hospitals: a systematic review and meta-analysis. European Psychiatry 52, 47–53.

Fazel S, Wolf A. (2017) Selecting a risk assessment tool in practice: a 10-point guide. Evidence-Based Mental Health

Fazel S, Wolf A, Larsson H, Lichtenstein P, Mallett S, Fanshawe TR. (2017) Identification of low risk violent crime in severe mental illness with a clinical prediction tool (Oxford Mental Illness and Violence tool [OxMIV]): a derivation and validation study. Lancet Psychiatry 4: 461-68.

Fazel S et al. (2016) Prediction of violent reoffending on release from prison: derivation and external validation of a scalable tool (OxRec). Lancet Psychiatry 3: 535-543

Wolf A at al. (2017) Prediction of violent crime on discharge from secure psychiatric hospitals: a clinical prediction rule (FoVOx). European Psychiatry http://dx.doi.org/10.1016/j.eurpsy.2017.07.011

Douglas T, Pugh J, Singh I, Savulescu J, Fazel S. (2017) Risk assessment tools in criminal justice and forensic psychiatry: the need for better data. European Psychiatry 42: 134-137.

Singh J, Grann M, Fazel S (2013) Authorship bias in violence risk assessment? A systematic review and meta-analysis. PLoS One 8(9): e72484.

Fazel S, Singh JP, Doll H, Grann M. (2012) Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis. BMJ 345:e4692.

Suicide in neuropsychiatric conditions

S Fazel, B Runeson. (2020) Suicide. New England Journal of Medicine; 382: 266-74

Yu R …. Fazel S. (2021) Factors associated with suicide risk among Chinese adults: a prospective cohort study of 0.5 million individuals. PLoS Medicine 18(3): e1003545

Fazel S, O’Reilly L. (2020) Machine learning for suicide research – can it improve risk factor identification? JAMA Psychiatry 77 (1):13-14

Chen Q, …, Fazel S. (2020) Predicting suicide attempt or suicide death following a visit to psychiatric speciality care: a machine learning study using Swedish national registry data. PLoS Medicine 27 (11): e1003416

Fazel S, A Wolf, H Larsson, S Mallett, TR Fanshawe. (2019) The prediction of suicide in severe mental illness: development and validation of a clinical prediction rule (OxMIS). Translational Psychiatry 9 (1), 98.

Chesney E, Goodwin GM, Fazel S. (2014) Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 13(2): 153-60.

Fazel S, Pillas D, Wolf A, Lichtenstein P, Långström N. (2014) Suicide, fatal accidents, and other causes of premature mortality in traumatic brain injury: A 41-year Swedish population study. JAMA Psychiatry 71(3): 326-33.

Fazel S, Wolf A, Långström N, Newton CR, Lichtenstein P. (2013) Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study. Lancet, 382(9905): 1646-54.

Forensic Psychiatry

Yukhnenko D, Blackwood N, Fazel S. (2020) Risk Factors for recidivism in individuals receiving community sentences: a systematic review and meta-analysis. CNS Spectrums 2020; 25 (2): 252-263

Wolf A, Whiting D, Fazel S.  (2017) Violence prevention in psychiatry: an umbrella review of interventions in general and forensic psychiatry. Journal of Forensic Psychiatry & Psychology 28: 659-673.

Fazel S, Fimińska Z, Cocks C, Coid J. (2016) Patient outcomes following discharge from secure psychiatric hospitals: Systematic Review and Meta-analysis. Br J Psychiatry 208(1): 17-25.

Pharmaco-epidemiology

Sariaslan A, Zetterqvist J, Lichtenstein P, Leucht S, Fazel S. (2021) Associations between individual antipsychotics and the risk of arrests and convictions of violent and other crime: a nationwide within-individual study of 74,925 persons. Psychological Medicine (in press)

Paljarvi T, Strang J, Quinn PD, Luciano S, Fazel S. (2021) Abuse-deterrent extended-release oxycodone and risk of opioid-related harm. Addiction 2021; Epub 4 January 2021: https://doi.org/10.1111/add.15392

Molero Y, Cipriani A, Larsson H, Lichtenstein P, D’Onofrio BM, Fazel S. (2020) Associations between statin use and suicidality, depression, anxiety and seizures: a Swedish total-population cohort study. Lancet Psychiatry 7 (11): 982-990

Molero Y, Larsson H, BM D’Onofrio, DJ Sharp, S Fazel. (2019) Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden. BMJ 365, l2147.

Molero Y et al (2018). Medications for alcohol and opioid use disorders and risk of suicidal behavior, accidental overdoses, and crime. American Journal of Psychiatry 175 (10), 970-978.

Molero Y, Lichtenstein P, Zetterqvist J, Gumpert CH, Fazel S. (2015) Selective serotonin reuptake inhibitors and violent crime: a cohort study. PLoS Medicine 12: e1001875.

Molero Y, Lichtenstein P, Zetterqvist J, Gumpert CH, Fazel S. (2015) Varenicline and risk of psychiatric conditions, suicidal behavior, criminal offending, and transport accidents and offences: population based cohort study. BMJ 350: h2388.

Fazel S, Zetterqvist J, Larsson H, Långström N, Lichtenstein P (2014). Antipsychotics, mood stabilizers, and risk of violent crime. Lancet, doi:10.1016/S0140-6736(14)60379-2.

Lichtenstein P et al. (2012) Medication for Attention Deficit–Hyperactivity Disorder and Criminality. N Engl J Med 367: 2006-14.

Homelessness

Nilsson SF, Nordentoft M, Fazel S, Laursen TM. (2020) Homelessness and police-recorded crime victimisation: a nationwide, register-based cohort study. Lancet Public Health 5: e333-e341

Fazel S, Geddes JR, Kushel M. (2014) The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet 384: 1529-40.

Selected book chapters

Fazel S, Toynbee M. Associations between psychiatric disorder and offending. In: New Oxford Textbook of Psychiatry. Oxford: OUP, 2020

Whiting D, Ryland R, Fazel S. Forensic mental health treatment and recidivism. In: The Routledge Handbook of the philosophy and science of punishment 2021. 

Fazel S, Bjørkly S (2016) “Methodological Considerations in Risk Assessment Research”, Singh JP, Bjørkly S, Fazel S (eds.) International Perspectives on Violence Risk Assessment (Oxford University Press).

Fazel S. Mental health assessment. In: Cambridge Handbook of Forensic Psychology (Cambridge University Press, 2010)

Books

Singh JP, Bjørkly S, Fazel S (eds.) 2016. International Perspectives on Violence Risk Assessment, Oxford University Press.

Other Activities

Section editor, BMC Psychiatry

Section editor, Evidence-Based Mental Health

International advisory board, The Lancet Psychiatry

Co-author of Continuing Professional Education module on Suicides in Prison hosted by the Royal College of Psychiatrists, UK (2015): http://www.psychiatrycpd.co.uk/learningmodules/suicidesinprison.aspx