Background: Childhood trauma is a risk factor for psychosis as well for violent behavior and offending later in life. Childhood trauma comprises subdomains of abuse and neglect that may be differently related to later violence among patients with schizophrenia. The aim of this study was to map the subdomains of childhood trauma associated with violent offending in schizophrenia. Methods: Information on childhood trauma from predominantly male patients with a DSM-IV diagnosis of schizophrenia and a history of violent offending (interpersonal violence) (SCZ-V, n = 19), schizophrenia patients without a history of violence (SCZ-NV, n = 34), and healthy controls (HC, n = 66) was obtained with the Childhood Trauma Questionnaire (CTQ). Differences between groups in total maltreatment scores and the five subdomains including physical, emotional, and sexual abuse, as well as physical and emotional neglect were analyzed. Results: SCZ-V had the highest median CTQ scores for all sub-domains. SCZ-V reported significantly higher total CTQ scores than SCZ-NV and HC. SCZ-V had significantly higher scores than HC on all subdomains, and significantly higher than SCZ-NV on physical and emotional neglect. SCZ-NV had higher scores on all domains except sexual abuse compared to HC. Conclusion: SCZ-V patients had higher exposure to childhood trauma than SCZ-NV, and both schizophrenia groups had higher exposure than HC. The results suggest that childhood physical and emotional neglect may be of specific importance to later violence in schizophrenia.
Psychiatric outpatients seem to have the most severe interpersonal problems along the agency dimension; that is, they have problems being assertive. Patients within different octant groups of the 64-item version of the Inventory of Interpersonal Problems system, corresponding to different kinds of specific, predominant interpersonal problems, have characteristic ways of relating to others, which ought to be identified and addressed in therapy.
The study material showed that there was a significant increase in psychiatric emergency admissions between 2000 and 2010. The rate of compulsory hospitalisation, measured among the population over the age of 18, remained unchanged during the period. The Norwegian Board of Health Supervision's care quality indicator for compulsory hospitalisation in mental health care can contribute to providing information and a basis of comparison for the use of compulsory hospitalisation, provided that the data submitted is quality assured. The highest increase was seen in the group of emergency admissions for mental disorders related to alcohol and illicit drug abuse as the principal diagnosis.
Associations between symptoms and interpersonal problems, assessed with the Symptom Checklist-90 (SCL-90-R) and the Inventory of Interpersonal Problems-64-item version (IIP-64), are examined in a large psychiatric outpatient sample. On the basis of the IIP-64 scores, the sample was divided into 8 subgroups, made up of different types of predominant interpersonal problems. These octant groups were used as independent variables in analyses testing hypothesized associations with symptom subscales of the SCL-90-R. In general, strong associations between symptoms and interpersonal problems were found. In addition, hostile and paranoid ideation symptoms displayed significant differences among octant groups, and were associated with interpersonal problems of the vindictive/self-centered kind. Phobic anxiety was associated with interpersonal problems of the socially inhibited kind. Assessing specific combinations of symptoms and interpersonal problems might be useful in treatment planning and evaluation.
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