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I read with great interest the recent article by Steadman et al¹ published in the May 1998 issue of the ARCHIVES. The finding of substance abuse being a major risk factor for violence in patients with a major mental disorder, especially schizophrenia, is not only confirmed by the English-language literature quoted by Steadman et al but also by many other clinical and epidemiological studies.^2-5 In a recent article Scott et al² reported results of a follow-up study in a comparatively small community sample of psychotic patients. Individuals with a dual diagnosis were significantly more likely to report a history of committing an offense or recent hostile behavior. In a subsequent analysis of the data of 2 large samples of schizophrenic patients (N=447 and N=192^3-4) it was shown that patients with comorbid substance abuse had been convicted more often than other schizophrenic patients (40.1% vs 13.7%). Lindquist and Allebeck⁵ in . . . [Full Text of this Article]