Misunderstood impulses: a phenomenological exploration of the experiences of violent behaviors in individuals with schizophrenia

Abstract Background Individuals with schizophrenia have a relatively elevated risk of violence compared with the general population. However, the subjective experiences underlying such behaviors remain poorly understood, hindering the development of effective violent prevention and management strategies. Objectives To explore the experiences of violent behaviors from the perspective of patients with schizophrenia. Methods We carried out a qualitative study using a descriptive phenomenological approach. Fifteen patients with stable schizophrenia were purposefully recruited from a specialist psychiatric hospital in Zhejiang, China. Data were collected through face-to-face semi-structured interviews between January and March 2025. Colaizzi’s seven-step method was used for theme analysis, supported by NVivo 12 software. Results Data analysis identified three themes and nine subthemes: (1) contributors toviolent behaviors (positive symptoms and poor medication adherence, adverse family environments and social discrimination, and stressful life events); (2) evolution of emotions and behaviors during the violent process (accumulation of negative emotions, out of control experience, and emotional reflection); and (3) needs for violence prevention and management (improved pharmacological and psychological treatment, family and social support, and non-coercive and person-centered care). Conclusion Violent behaviors among individuals with schizophrenia are shaped by multiple interacting factors and dynamic emotional processes. Effective violence prevention requires a comprehensive, person-centered approach integrating symptom management, emotional support, and family and social resources while promoting non-coercive and person-centered care. Clinical trial number Not applicable.