A systematic review of 24 studies was conducted with the aim to determine the absolute and relative risks of perpetrating violence toward others in individuals with schizophrenia spectrum disorders compared with the general population.

• The included studies were case-control and cohort studies that allowed comparison of the risks of interpersonal violence perpetration and/or violent criminality in individuals with schizophrenia spectrum disorders vs a general population group without these disorders.

• In a subgroup of register-based studies, perpetrating violence was observed at an absolute risk of less than 1 in 20 in women with schizophrenia spectrum disorders and less than 1 in 4 in men with schizophrenia spectrum disorders over a 35-year period.

• Women with schizophrenia spectrum disorders had higher elevated relative risk for all violence-perpetration outcomes compared with men with schizophrenia spectrum disorders, but there was substantial heterogeneity in the findings.

• Based on findings, researchers suggest that it may be important to target violence perpetration outcomes for prevention and to lower stigma in people with schizophrenia spectrum disorders.