Aggressiveness and violence in psychiatric patients: a clinical or social paradigm?

Abstract

ObjectivePsychiatric disorders are often considered the leading cause of violence. This may be due to a stereotype created by media and general opinion.MethodThe Modified Overt Aggression Scale (MOAS) was used to evaluate the severity of aggressive and violent behaviors in 400 patients who attended a post-acute psychiatric service in Milan from 2014 to 2016 and suffered from different psychiatric disorders. The psychopathological clinical picture was evaluated by Clinical Global Impression (CGI). The study also assessed the possible correlation between epidemiologic and sociodemographic factors, clinical variables, and aggression and violence.ResultsOf the total number of subjects, 21.50% showed a MOAS score >0, 11.50% presented mild aggression (0–10 MOAS weighted score), 9% moderate aggression (11–20), and 1% severe aggression (MOAS >20). With respect to violent behaviors, 16% of patients showed a score >0 in one MOAS subscale other than verbal aggression according to violence definition. The severity of clinical picture seemed to be related to higher weighted MOAS score. Multivariate testing of different sociodemographic and clinical variables showed that violence was related to unemployment status, and significantly correlated to compulsory admission (TSO), suicide attempts (TS), and personality disorders, while the severity of clinical psychiatric picture seemed to play a secondary role.ConclusionResults have shown that personality disorders and sociodemographic factors, including economic factors, seem to be major determinants of violence among patients diagnosed with mental disorders.

Influencing factors of multiple adverse outcomes among schizophrenia patients using count regression models: a cross-sectional study

“…Being male and early in age were the common risk factors [11][12][13]. Other socio-demographic characteristics also serve as the risk factors for violence, including unemployment, lower levels of education, single status, and lower income [11,14,15]. Previous studies suggested that these adverse outcomes were also associated with a history of adverse outcomes, drug use, and a family history of psychiatric illness [13][14][15].…”

Psychopathy, temperament, and character dimensions of personality as risk determinants of criminal recidivism in schizophrenia patients

“…In fact, compared with the general population, schizophrenia patients were reported to have an almost 14-fold higher risk of being a victim of violent offense [1,2]. However, with the acceleration of deinstitutionalization in the treatment of schizophrenia patients out of hospital, a plethora of clinical studies conducted since the early 1990s suggest that there is an increasing number of patients with schizophrenia entering into the criminal justice system as perpetrators [2][3][4][5]. Recent register-based studies with large sample sizes and meta-analyses have consistently suggested that individuals with a psychotic disorder, including schizophrenia, were 2-8 times more likely to commit violent or nonviolent offenses [6][7][8].…”

Influencing Factors of Multiple Adverse Outcomes Among Schizophrenia Patients Using Count Regression Models: A Cross-Sectional Study

“…Being male and early in age were the common risk factors [10][11][12]. Other socio-demographic characteristics were risk factors of violence, including unemployment, lower levels of education, single status, and lower income [10,13,14]. Some studies also suggested that these adverse outcomes were associated with a history of these outcomes, a history of drug use, and a family history of psychiatric illness [12][13][14].…”

“…Some studies also suggested that these adverse outcomes were associated with a history of these outcomes, a history of drug use, and a family history of psychiatric illness [12][13][14]. Other clinical factors including hospitalizations, lower satisfaction, or treatment adherence had been suggested in some studies [11,13,15]. However, the previous researches investigated these outcomes separately.…”

“…Other socio-demographic characteristics were risk factors of violence, including unemployment, lower levels of education, single status, and lower income [10,13,14]. Some studies also suggested that these adverse outcomes were associated with a history of these outcomes, a history of drug use, and a family history of psychiatric illness [12][13][14]. Other clinical factors including hospitalizations, lower satisfaction, or treatment adherence had been suggested in some studies [11,13,15].…”