Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis

Abstract

Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: “forensic” AND “Positive and Negative Syndrome Scale” OR “PANSS”. A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed.Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021)

Nanosystems for Brain Targeting of Antipsychotic Drugs: An Update on the Most Promising Nanocarriers for Increased Bioavailability and Therapeutic Efficacy

“…Among them, schizophrenia and bipolar disorder are the most prevalent, affecting around 24 and 40 million people worldwide over the last decade, respectively [ 1 , 2 , 3 , 4 , 5 ]. Schizophrenia is a chronic disorder, most commonly beginning in late adolescence and early adulthood, characterized by the presence of positive symptoms, such as hallucinations, delusions and significant and intense changes in thought and behavior (such as self or hetero-aggressiveness, agitation and bizarre attitudes), negative symptoms, such as dementia, impairment of interpersonal relationships, social isolation, apathy, alogia, anhedonia and lack of motivation and initiative to perform ordinary everyday activities, and cognitive symptoms, such as marked deficits in verbal and working memory, vigilance and attention [ 6 , 7 , 8 , 9 , 10 ]. In turn, bipolar disorder is also a chronic mental illness, typically characterized by either recurrent depressive episodes, including feelings of deep sadness and energy loss, or episodes of mania/hypomania, including periods during which people feel overly exhilarated, happy, irritable and/or energetic, with a reduced need to sleep [ 11 , 12 , 13 ].…”

Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence

“…It should be noted that while patients with SCH are more likely to engage in violent behaviors (8), only a fraction of violent offenders have SCH (9,10). As a result of psychotic symptoms, SCH patients frequently exhibit aggressivity (11)(12)(13), especially during an acute episode (14,15). Previous studies have demonstrated that patients with psychopathological conditions were more prone to engage in aggressive actions when suffering from auditory hallucinations, particularly command hallucinations (16,17).…”