A systematic review and meta‐regression analysis of aggression during the <scp>F</scp>irst <scp>E</scp>pisode of <scp>P</scp>sychosis

Winsper, Catherine; Ganapathy, Ramanathan; Marwaha, Steven; Large, Matthew; Birchwood, Max; Singh, Swaran P.

doi:10.1111/acps.12113

Cited by 105 publications

(110 citation statements)

References 52 publications

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“…29 This may explain, in part, why rates of aggression during FEP appear not to alter substantially following service contact. 30 While in crude analyses, moderate premorbid delinquency increased the risk for violence during FEP, it was not independently associated with violence once all risk factors were controlled for. The path analysis suggested the increased risk was partially mediated by positive symptoms (ie, moderate pre- morbid delinquency was associated with higher positive symptom scores, which were associated with an increased risk for violent behavior).…”

Section: Discussionmentioning

confidence: 94%

Pathways to Violent Behavior During First-Episode Psychosis

et al. 2013

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IMPORTANCE Although many studies have explored the correlates of violence during first-episode psychosis (FEP), most have simply compared violent psychotic individuals with nonviolent psychotic individuals. Accumulating evidence suggests there may be subgroups within psychosis, differing in terms of developmental processes and proximal factors associated with violent behavior.OBJECTIVE To determine whether there are subgroups of psychotic individuals characterized by different developmental trajectories to violent behavior. DESIGN, SETTING, AND PARTICIPANTSThe National EDEN (Evaluating the Development and Impact of Early Intervention Services in the West Midlands) Study longitudinal cohort assessed premorbid delinquency (premorbid adjustment adaptation subscale across childhood and adolescence), age at illness onset, duration of untreated psychosis, past drug use, positive symptoms, and violent behavior. Group trajectories of premorbid delinquency were estimated using latent class growth analysis, and associations with violent behavior were quantified. This study included 6 early intervention services in 5 geographical locations across England, with violent behavior information available for 670 first-episode psychosis cases. MAIN OUTCOMES AND MEASURESViolent behavior at 6 or 12 months following early intervention services entry.RESULTS Four groups of premorbid delinquency were identified: stable low, adolescent-onset high to moderate, stable moderate, and stable high. Logistic regression analysis, with stable low delinquency as the reference group, demonstrated that moderate (odds ratio, 1.97; 95% CI, 1.12-3.46) and high (odds ratio, 3.53; 95% CI, 1.85-6.73) premorbid delinquency trajectories increased the risk for violent behavior during FEP. After controlling for confounders, path analysis demonstrated that the increased risk for violence in the moderate delinquency group was indirect (ie, partially mediated by positive symptoms) (probit coefficient [β] = 0.12; P = .002); while stable high delinquency directly increased the risk for violence (β = 0.38; P = .05). CONCLUSIONS AND RELEVANCEThere appear to be diverse pathways to violent behavior during FEP. Stable high premorbid delinquency from childhood onwards appears to directly increase the risk for violent behavior, independent of psychosis-related risk factors. In addition to tackling illness-related risks, treatments should directly address antisocial traits as a potent risk for violence during FEP.

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Section: Discussionmentioning

confidence: 94%

Pathways to Violent Behavior During First-Episode Psychosis

et al. 2013

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“…First, heterogeneity could not be adequately adjusted by subgroup analyses, in line with the notion that heterogeneity is difficult to be avoided in a meta-analysis of epidemiological surveys (Long et al, 2014;Winsper et al, 2013). Second, no studies examined smoking in nonHan Chinese patients with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Smoking in male patients with schizophrenia in China: A meta-analysis

Cao

Zhong

et al. 2016

Drug and Alcohol Dependence

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“…Third, heterogeneity could not be adequately adjusted for by subgroup analyses, which is consistent with the notion that heterogeneity cannot be avoided in a meta-analysis of epidemiological surveys. 55,56 In conclusion, short sleep duration and unhealthy sleep pattern are common in Chinese university students. Its associated sociocultural factors warrant further investigation.…”

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confidence: 87%

Sleep Duration and Sleep Patterns in Chinese University Students: A Comprehensive Meta-Analysis

Wang

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives:This meta-analysis aimed to determine duration and patterns of sleep in Chinese university students. Methods: English (PubMed, PsycINFO, Embase) and Chinese (SinoMed, Wan Fang Database, and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until August 16, 2016. Data on sleep duration and sleep patterns of tertiary student population in eligible studies were extracted and pooled using random-effects models. Results: A total of 57 studies with 82,055 university students were included in the meta-analysis. Pooled mean sleep duration was 7.08 h/d (95% confidence interval [CI]: 6.84 to 7.32 h/d). The percentage of students with sleep duration shorter than 6 h/d and 7 h/d (short sleep) was 8.4% (95% CI: 5.7% to 12.3%) and 43.9% (95% CI: 36.9% to 51.1%), respectively. In contrast, the percentage of students with sleep duration longer than 8 hours and 9 hours (long sleep) was 18.3% and 5.7%, respectively. The pooled mean bedtime was at 12:51 am. The percentage of university students who fall asleep after midnight was 23.8%. The percentage of students with sleep latency more than 30 minutes was 25.5%. The pooled mean wake-up time was at 8:04 am on weekdays and 9:52 am on weekends. Conclusions: Short sleep duration and unhealthy sleep patterns were found to be common among Chinese university students. Keywords: China, meta-analysis, sleep duration, sleep patterns, university students Citation: Li L, Wang YY, Wang SB, Li L, Lu L, Ng CH, Ungvari GS, Chiu HF, Hou CL, Jia FJ, Xiang YT. Sleep duration and sleep patterns in chinese university students: a comprehensive meta-analysis.

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A systematic review and meta‐regression analysis of aggression during the First Episode of Psychosis

Abstract: Rates of aggression are high during FEP, both before and following initial service contact, and seem not to alter following contact. This conclusion remains tentative due to considerable heterogeneity between studies and a lack of prospective cohort studies.

Cited by 105 publications

References 52 publications

Pathways to Violent Behavior During First-Episode Psychosis

Pathways to Violent Behavior During First-Episode Psychosis

Smoking in male patients with schizophrenia in China: A meta-analysis

Sleep Duration and Sleep Patterns in Chinese University Students: A Comprehensive Meta-Analysis

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