Violent behavior in schizophrenic patients: relationship with clinical symptoms

Abstract

Considerable evidence suggests that violent behavior observed in schizophrenic patients is motivated by psychotic symptomatology. The understanding of violence in schizophrenic patients requires consideration of psychiatric symptomatology. Objective: This study investigated the relationship between violent behavior and psychiatric symptomatology in schizophrenic patients. Method: One hundred and thirteen patients were recruited. Thirteen patients were excluded due to concomitant substance abuse six months prior to the assessment. Diagnoses were based on the SCID-I. Psychotic symptom severity was assessed with the PANSS. Violent behaviors were assessed with the OAS. Results: Violent behaviors were associated with more severe psychotic symptomatology including hallucinations, delusions, excitement, poor impulse control, and thinking disturbances. Conclusions: Patients with exacerbation of psychotic symptomatology have an increased risk of violent behavior. It is necessary to determine which subtypes of hallucinations and delusions are implicated in the association of schizophrenia and violent behavior. Violent behavior in schizophrenic patients is a heterogeneous phenomenon best explained in the context of specific symptoms associated with violence and course of illness. The retrospective assessment of the variables raises methodological questions concerning the reliability of measurement of the impact of psychotic symptoms on violence. Aggr. Behav. 31:511-520, 2005. r

Mental health‐related risk factors for violence: using the evidence to guide mental health triage decision making

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The Relationship Between Childhood Maltreatment and Violence to Others in Individuals With Psychosis: A Systematic Review and Meta-Analysis

“…The suggestion that individuals with schizophrenia are more at risk of perpetrating violence than normal controls has led researchers to consider specific symptoms of psychosis. Some studies have suggested that one route to violence in psychosis is suffering acute symptoms (Volavka, 2013), and that more severe psychotic symptoms may be linked to greater violence (Fresán et al, 2005). Recent reviews have suggested that the content of psychotic symptomology may be relevant.…”

Self-report and laboratory measures of impulsivity in patients with schizophrenia or schizoaffective disorder and healthy controls

“…Risk for aggression is increased in patients with schizophrenia compared to individuals without serious mental illness (Swanson et al, 1990; Steadman et al, 1998; Brennan et al, 2000). Positive psychotic symptoms may be more severe in violent schizophrenic patients (Krakowski et al, 1999; Fresán et al, 2005), however, frontally mediated functions such as social cognition (Weiss et al, 2006) and impulse control (Hoptman et al, 2002; Kumari et al, 2009) are also impaired and there is evidence for relationships between frontotemporal disconnections and aggression (Hoptman et al, 2002; Hoptman et al, 2010). Aggression is also increased in non-psychotic conditions that affect impulse control.…”