Aggressive behaviour in antipsychotic‐naive first‐episode schizophrenia patients, their unaffected siblings and healthy controls

Abstract

Aim While patients with schizophrenia are more likely to be victims rather than perpetrators of aggressive behaviour, prior research has shown increased rates of aggressive behaviours in these patients that appear very early in the course of illness. We aimed to assess aggression in antipsychotic‐naive first‐episode schizophrenia patients, their healthy siblings, and controls; and to investigate correlates of aggression in the patients group. Methods Patients (N = 55), siblings (N = 55) and healthy controls (N = 71) were evaluated on Buss and Perry Aggression Questionnaire (AQ), Life History of Aggression (LHA), Barratt Impulsiveness Scale, and Levenson Self‐Report Psychopathy Scale. Age, gender and substance use were regarded as covariates, and differences between the three groups were evaluated using analysis of covariance. Hierarchical regression was performed to determine which variables were associated with aggression level in the patients group. Results The Tukey multiple comparison test showed that both patients (p < .001) and siblings (p = .023) scored higher on the LHA Aggression than controls. Siblings scored higher than controls (p = .010) for the Anger subscale of the AQ. Patients scored significantly higher than controls in the three impulsiveness dimensions; whereas siblings scored higher than controls in the motor (p = .023) and non‐planning (p = .004) dimensions. Multivariate analyses showed that, after controlling for confounders, only attentional impulsiveness (β = .446, p = .0244) and psychopathy traits (β = .359, p = .010) helped predict AQ total scores among patients. Conclusion Aggression and some of its risk factors including impulsiveness are likely to be trait variables that might provide important vulnerability markers for people at heightened risk of developing psychosis.

Systematic Review and Meta-analysis: Rates of Violence During First-Episode Psychosis (FEP)

“…However, the time periods were highly varied. The timepoint before treatment (ie, “before presentation to services”) ranged from an undefined period 11 , 12 , 27 , 36 , 39 , 53 , 54 to 3 months before treatment initiation, 26 and the follow-up period (ie, “after presentation to services”) ranged between 4 weeks 43 and 10 years 14 following entry to services (see table 2 ). These services typically included specialized early intervention programs, 39 , 50 hospital admissions, 14 , 43 and other unspecialized treatments in the broader community.…”

“…A meta-analysis of 17 studies 11 , 12 , 14 , 21 , 27 , 28 , 30 , 32 , 39 , 43 , 47 , 48 , 50 , 51 , 54 including 4269 participants, found a pooled prevalence of 13.4% (95% CI [9.0%–19.5%]) for any violence, regardless of timepoint (ie, before presentation, at first presentation or after presentation to services). This value included less serious, 14 , 21 , 39 , 49 , 55 serious, 11 , 12 , 14 , 21 , 22 , 25–27 , 30 , 32 , 39 , 48 , 50 , 51 and severe 25 , 43 , 50 , 51 violence.…”

“…The pooled proportion of any violence before entry to services was 11.6% (95% CI [6.8%–18.9%]; see Supplementary figure 5 ). This figure was pooled from 11 studies, 11 , 12 , 21 , 22 , 26–28 , 32 , 39 , 50 , 54 which included a total of 3415 participants. The prevalence ranged between 3.8% 50 and 38.2%.…”

Child abuse and aggressiveness in individuals diagnosed with schizophrenia in Lebanon

“…Childhood trauma has been demonstrated to be a risk factor for violent behavior later in life in various nonclinical populations (Ross & Arsenault, 2018; Temple et al, 2018). Despite the well‐known increased risk of aggressiveness among patients with psychotic disorders (Fekih‐Romdhane, 2022), and prior evidence showing high prevalence rates of childhood trauma in psychosis (Fekih‐Romdhane et al, 2019), a very limited number of studies are available on the association between early maltreatment and aggressive behavior in patients with schizophrenia (Storvestre et al, 2020). The first systematic review and meta‐analysis on this topic were published in 2019 by Green and coworkers and identified only five English language studies investigating this association among adults with psychosis (Green et al, 2019).…”