Clinical and neuropsychological features of violence in schizophrenia: A prospective cohort study

Bulgari, Viola; Iozzino, Laura; Ferrari, Clarissa; Picchioni, Marco; Candini, Valentina; Francesco, Alessandra De; Maggi, Paolo; Segalini, Beatrice; Girolamo, Giovanni de

doi:10.1016/j.schres.2016.10.016

Cited by 36 publications

(21 citation statements)

References 35 publications

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“…Multiple GLM analysis also showed that PCSU were more likely to show violent behavior. Consistent with previous results (Bulgari et al, 2017), personality disorders and low negative BPRS-E symptoms must be considered, especially for residential patients with current use. Our findings suggest that specific interventions to reduce aggressive and violent behavior should be targeted toward patients with this clinical profile.…”

Section: Discussionsupporting

confidence: 87%

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Cavalera

Ferrari

Bianconi³

et al. 2020

Aust N Z J Psychiatry

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Objective: The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. Methods: A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. Results: The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. Conclusion: These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and community safety.

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Section: Discussionsupporting

confidence: 87%

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Cavalera

Ferrari

Bianconi³

et al. 2020

Aust N Z J Psychiatry

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“…Italian clinical studies showed a direct correlation between symptoms of acute psychosis and the occurrence of aggressive behaviors, with the presence of disorientation, motor hyperactivity, hostility-suspiciousness, grandiosity and borderline and passive-aggressive personality traits predicting a change for the worse in aggressive behavior, from verbal to physical [ Another recent Italian cohort study [73] investigated the relationship between clinical and neuropsychological factors with risk of aggression in inpatients with schizophrenia. Physically aggressive patients showed a higher number of compulsory admissions, higher anger, and less negative symptoms as compared to non-aggressive patients.…”

Section: Psychiatric Diagnosismentioning

confidence: 99%

“…A recent cohort Italian study [73] compared a sample of patients with schizophrenia and a history of physical aggression to patients with schizophrenia matched by age, gender, and alcohol abuse but without such a history. During a 1-year follow-up, patients with a history of aggression resulted more likely to be violent.…”

Section: History Of Aggressionsmentioning

confidence: 99%

Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience

Caruso

Antenora

Riba

et al. 2021

Curr Psychiatry Rep

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Purpose of Review We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience. Recent Findings A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Summary Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need to undertake initiatives aimed to enhance understanding, prevention, and management of violence in general hospital settings across Europe.

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“…Another strong predictor of aggressive behavior is a history of violence. This result is confirmed by the VIORMED project (Bulgari et al [12]; Candini et al [14]; de Girolamo et al [21]) and by several studies on patients with SMD and/or offenders (Fazel et al [25,26]; Lund et al [38]). At the same time, the present study points out that people with a history of violence are characterized more frequently by poor metacognitive functioning compared to patients without such history; this data is supported by other studies [1,2,30].…”

Section: Predictors Of Aggressive and Violent Behavior And The Role Omentioning

confidence: 58%

Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders

Candini

Ghisi

Bianconi³

et al. 2020

Ann Gen Psychiatry

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Background: Metacognitive functions play a key role in understanding which psychological variables underlying the personality might lead a person with a severe mental disorder to commit violent acts against others. The aims of this study were to: (a) investigate the differences between patients with poor metacognitive functioning (PM group) and patients with good metacognitive functioning (GM group) in relation to a history of violence; (b) investigate the differences between the two groups in relation to aggressive behavior during a 1-year follow-up; and (c) analyze the predictors of aggressive behavior. Methods: In a prospective cohort study, patients with severe mental disorders with and without a lifetime history of serious violence were assessed with a large set of standardized instruments and were evaluated bimonthly with MOAS in order to monitor any aggressive behavior. The total sample included 180 patients: 56% outpatients and 44% inpatients, and the majority were male (75%) with a mean age of 44 (± 9.8) years, and half of them had a history of violence. The sample was split into two groups: poor metacognition (PM) group and good metacognition (GM) group, according to MAI evaluation scores. Results: The PM patients reported a history of violence more frequently than GM patients, during the 1-year followup, but no differences between groups in aggressive and violent behavior were found. The strongest predictors of aggressive behavior were: borderline and passive-aggressive personality traits and a history of violence, anger, and hostility. The metacognitive functions alone did not predict aggressive behavior, but metacognitive functions interacted with hostility and angry reactions in predicting aggressive behavior. Conclusions: This study led to some important conclusions: (a) some aspects closely related to violence are predictive of aggressive behavior only in patients with poor metacognition, thus good metacognition is a protective factor; (b) poor metacognition is associated with a history of violence, which in turn increases the risk of committing aggressive behavior.

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Clinical and neuropsychological features of violence in schizophrenia: A prospective cohort study

Cited by 36 publications

References 35 publications

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience

Aggressive behavior and metacognitive functions: a longitudinal study on patients with mental disorders

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