Impulsivity in early psychosis: A complex link with violent behaviour and a target for intervention

Moulin, Valérie; Golay, Philippe; Palix, Julie; Baumann, Pierre; Gholam‐Rezaee, Mehdi; Azzola, A.; Gasser, Jacques; Q., Kim; Alameda, Luis; Conus, Philippe

doi:10.1016/j.eurpsy.2017.12.003

Cited by 35 publications

(36 citation statements)

References 49 publications

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“…It could however worsen with the emergence of psychosis, especially with the occurrence of positive symptoms. In another study we have shown indeed that the impact of impulsivity on the probability of VB was potentiated when associated with a low level of insight and a high level of positive symptoms (Moulin et al, ).…”

Section: Discussionmentioning

confidence: 87%

Violent behaviour in early psychosis patients: Can we identify clinical risk profiles?

Moulin

Palix

Golay

et al. 2017

Early Intervention Psych

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Section: Discussionmentioning

confidence: 87%

Violent behaviour in early psychosis patients: Can we identify clinical risk profiles?

Moulin

Palix

Golay

et al. 2017

Early Intervention Psych

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“…As for other PANSS items, we selected items that were previously associated with aggression or incorporated in the same PANSS cluster as hostility: P4 excitement, G4 tension, G8 uncooperativeness and G14 poor impulse control (4,6,22,23). Excitement indicates "hyperactivity as reflected in accelerated motor behavior, heightened responsivity to stimuli, hypervigilance or excessive mood lability".…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Hostile behavior can decrease the quality of life and has been associated with poorer social functioning (2). Several demographic and clinical risk factors have been reported such as male sex, socioeconomic deprivation, cannabis use, suicidality and clinical symptoms such as impulsiveness and excitement (3)(4)(5)(6)(7)(8), although there are some differences between these studies.…”

Section: Introductionmentioning

confidence: 99%

Aggressive Behavior, Hostility, and Associated Care Needs in Patients With Psychotic Disorders: A 6-Year Follow-Up Study

Faay¹,

Os²

2020

Front. Psychiatry

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Background: Hostility and aggressive behavior in patients with psychotic disorders are associated with demographic and clinical risk factors, as well as with childhood adversity and neglect. Care needs are an essential concept in clinical practice; care needs in the domain of safety for others reflect the actual problem the patient has. Hostility, aggressive behavior, and associated care needs, however, are often studied in retrospect.Method: In a sample of 1,119 patients with non-affective psychotic disorders, who were interviewed three times over a period of 6 years, we calculated the incidence of hostility, self-reported maltreatment to others and care needs associated with safety for other people (safety-to-others). Regression analysis was used to analyze the association between these outcomes and risk factors. The population attributable fraction (PAF) was used to calculate the proportion of the outcome that could potentially be prevented if previous expressions of adverse behavior were eliminated.Results: The yearly incidence of hostility was 2.8%, for safety-to-others 0.8% and for maltreatment this was 1.8%. Safety-to-others was associated with previous hostility and vice versa, but, assuming causality, only 18% of the safety-to-others needs was attributable to previous hostility while 26% was attributable to impulsivity. Hostility, maltreatment and safety-to-others were all associated with number of unmet needs, suicidal ideation and male sex. Hostility and maltreatment, but not safety-to-others, were associated with childhood adversity. Neither safety-to-others, maltreatment nor hostility were associated with premorbid adjustment problems.Conclusion: The incidence of hostility, self-reported aggressive behaviors, and associated care needs is low and linked to childhood adversity. Known risk factors for prevalence also apply to incidence and for care needs associated with safety for other people. Clinical symptoms can index aggressive behaviors years later, providing clinicians with some opportunity for preventing future incidents.Next to these three outcome measures, demographic items and known clinical and early risk factors were incorporated in the analysis.

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“…Analyses were conducted on 250 patients (188 NVPs and 62 VPs). The main VB characteristics (described previously [27,49]) were physical aggression, robbery with physical aggression, and assault and battery.…”

Section: Violent Behaviors During the Programmentioning

confidence: 99%

Early onset of cannabis use and violent behavior in psychosis

et al. 2020

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Background: Although evidence from psychosis patients demonstrates the adverse effects of cannabis use (CU) at a young age and that the rate of CU is high in subgroups of young violent patients with psychotic disorders, little is known about the possible effect of the age of onset of CU on later violent behaviors (VB). So, we aimed to explore the impact of age at onset of CU on the risk of displaying VB in a cohort of early psychosis patients. Method: Data were collected prospectively over a 36-month period in the context of an early psychosis cohort study. A total of 265 patients, aged 18–35 years, were included in the study. Logistic regression was performed to assess the link between age of onset of substance use and VB. Results: Among the 265 patients, 72 had displayed VB and 193 had not. While violent patients began using cannabis on average at age 15.29 (0.45), nonviolent patients had started on average at age 16.97 (0.35) (p = 0.004). Early-onset CU (up to age 15) was a risk factor for VB (odds ratio = 4.47, confidence interval [CI]: 1.13–20.06) when the model was adjusted for age group, other types of substance use, being a user or a nonuser and various violence risk factors and covariates. History of violence and early CU (until 15) were the two main risk factors for VB. Conclusions: Our results suggest that early-onset CU may play a role in the emergence of VB in early psychosis.

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Impulsivity in early psychosis: A complex link with violent behaviour and a target for intervention

Abstract: Early intervention strategies in psychotic disorders should include evaluation of impulsivity considering it is linked to increased risk of VB and may respond to treatment.

Cited by 35 publications

References 49 publications

Violent behaviour in early psychosis patients: Can we identify clinical risk profiles?

Violent behaviour in early psychosis patients: Can we identify clinical risk profiles?

Aggressive Behavior, Hostility, and Associated Care Needs in Patients With Psychotic Disorders: A 6-Year Follow-Up Study

Early onset of cannabis use and violent behavior in psychosis

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