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

Cavalera, Cesare; Ferrari, Clarissa; Bianconi, Giorgio; Bulgari, Viola; Candini, Valentina; Carrà, Giuseppe; Clerici, Massimo; Conte, Giovanni; Cricelli, Marta; Ferla, Maria Teresa; Iozzino, Laura; Macis, Ambra; Stefana, Alberto; Ornaghi, Annalisa; Girolamo, Giovanni de

doi:10.1177/0004867420963732

Cited by 9 publications

(3 citation statements)

References 38 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with comorbid SUD scored higher than non-SUD patients on the BPRS hostility subscale. There is evidence that SUD is related to violent behavior ( 99 ); substance use patterns in people with addiction may be related to coping styles associated with aggression and hostility ( 100 ). In our study, patients' scores on the hostility subscale of the BRPS decreased over time, independently of whether they had SUD comorbidity or not.…”

Section: Discussionmentioning

confidence: 99%

Brexpiprazole in patients with schizophrenia with or without substance use disorder: an observational study

Lombardozzi,

Trovini,

Amici

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

BackgroundPartial dopamine D2 receptor agonists are used for psychotic symptoms in adults with schizophrenia spectrum disorders. Recently, interest surged for partial dopamine D2 receptor agonists in substance use disorders (SUDs). Since it is believed that SUDs decrease the efficacy of pharmacotherapy of underlying psychiatric disorders, we tested the efficacy of the partial D2 agonist brexpiprazole in patients with schizophrenia who were either comorbid with a SUD (SUD group) or not comorbid (non-SUD) to assess treatment response and the effect of brexpiprazole on substance craving in SUD.MethodsWe included patients with DSM-5/DSM-5-TR schizophrenia (using SCID-5-CV) aged 18–66 years with either comorbid SUD or non-SUD to treat with brexpiprazole 4 mg/day for 6 months during February–October 2022. Patients were assessed with the Clinical Global Impressions–Severity (CGI-S) scale, the 24-item Brief Psychiatric Rating Scale (BPRS), and the Positive And Negative Syndrome Scale (PANSS) at baseline, weekly for the first 2 months and monthly for the next four. Furthermore, we assessed substance craving in SUD with a visual analog scale for craving (VAScrav) at the same timepoints.ResultsThe total sample was 86 (85 analysable) 18- to 64-year-old (mean 39.32 ± 14.09) patients with schizophrenia [51 men (59.3%) and 35 women (40.7%)], of whom 48 SUD (55.8%) (37 men and 11 women) and 38 non-SUD (44.2%) (14 men and 24 women). No serious or persistent adverse events developed over the study period, but one patient dropped out for subjective akathisia. Results indicated the main effects of time with improvements over the course of the study for CGI-S, BPRS, and PANSS in both SUD and non-SUD groups and the entire sample, and for VAScrav in SUD. Brexpiprazole was associated with similar significant improvements in both groups at the 6 month endpoint compared to baseline.ConclusionTreatment with brexpiprazole for 6 months improved psychotic symptoms in patients with schizophrenia, independently from whether they belonged to the SUD or the non-SUD group; hence, SUD comorbidity did not confer treatment resistance to brexpiprazole. Furthermore, in the SUD group, we observed reduced substance craving.

show abstract

Section: Discussionmentioning

confidence: 99%

Brexpiprazole in patients with schizophrenia with or without substance use disorder: an observational study

Lombardozzi,

Trovini,

Amici

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…It is clear that some people with psychotic disorders can engage in severe violence even in absence of alcohol and substance use (Fazel et al, 2009 ; Gosek, Kotowska, Rowińska-Garbień, Bartczak, & Heitzman, 2020 ; Volavka, 2014 ). Equally alcohol and substance misuse remains one of the main potentially modifiable risk factors for the prevention of violence in people with SSDs (Cavalera et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

A multinational case−control study comparing forensic and non-forensic patients with schizophrenia spectrum disorders: the EU-VIORMED project

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background The relationship between schizophrenia and violence is complex. The aim of this multicentre case–control study was to examine and compare the characteristics of a group of forensic psychiatric patients with a schizophrenia spectrum disorders and a history of significant interpersonal violence to a group of patients with the same diagnosis but no lifetime history of interpersonal violence. Method Overall, 398 patients (221 forensic and 177 non-forensic patients) were recruited across five European Countries (Italy, Germany, Poland, Austria and the United Kingdom) and assessed using a multidimensional standardised process. Results The most common primary diagnosis in both groups was schizophrenia (76.4%), but forensic patients more often met criteria for a comorbid personality disorder, almost always antisocial personality disorder (49.1 v. 0%). The forensic patients reported lower levels of disability and better social functioning. Forensic patients were more likely to have been exposed to severe violence in childhood. Education was a protective factor against future violence as well as higher levels of disability, lower social functioning and poorer performances in cognitive processing speed tasks, perhaps as proxy markers of the negative syndrome of schizophrenia. Forensic patients were typically already known to services and in treatment at the time of their index offence, but often poorly compliant. Conclusions This study highlights the need for general services to stratify patients under their care for established violence risk factors, to monitor patients for poor compliance and to intervene promptly in order to prevent severe violent incidents in the most clinically vulnerable.

show abstract

“…UA elevation has been found to be associated with impulsivity, disinhibition, aggression, and sensation seeking behavior [15]. Impulsivity, hostility, aggression, irritability, and sensation-seeking behavior are known to be common in patients with substance use disorder [16,17]. There are not enough studies in the literature evaluating the serum UA level in these patients.…”

mentioning

confidence: 99%

The relationship between serum uric acid levels and severity of addiction in individuals with substance use disorders

Turan

Ünal

2023

The European Research Journal

View full text Add to dashboard Cite

Objectives: The aim of this study was to compare serum uric acid levels in patients with methamphetamine and synthetic cannabinoid use disorders pre- and post-detoxification treatment with healthy controls. Secondly, to determine the relationship between the serum uric acid levels of the cases and the severity of the addiction. Methods: Fifty methamphetamine, 50 synthetic cannabinoids, and 40 healthy controls were evaluated on the specified dates. Venous blood samples were taken from the participants to measure serum uric acid and creatinine levels. The arrangement was made by taking the Uric acid/creatinine ratio to neutralize the confounding effect of kidney functions. The Addiction Profile Index was applied to determine the severity of substance abuse in the case group. Results: A statistically significant difference was found between the uric acid values of all three groups when the One-way ANOVA test was performed (p < 0.001). UA values were significantly lower in the case groups than in the healthy control group. When the substance use characteristics of the case groups were compared, a statistically significant difference was found in the duration of substance use (p < 0.010) and motivation (p = 0.031) subtests. Duration of substance use and craving were higher in the synthetic substance group, and motivation was higher in the methamphetamine group. According to the Pearson analysis, the severity of addiction was deduced not to be correlated with serum uric acid and uric acid/creatinine levels in both case groups. Conclusions: Serum uric acid and uric acid/creatinine levels were found to be statistically significantly lower in individuals with methamphetamine and synthetic cannabinoid exposure compared to healthy controls. In this study, it was thought that the lower uric acid levels in the case group compared to the control group may be due to the use of uric acid as an antioxidant or a decrease in purinergic transformation. Future studies may focus on making this distinction.

show abstract

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

Cited by 9 publications

References 38 publications

Brexpiprazole in patients with schizophrenia with or without substance use disorder: an observational study

Brexpiprazole in patients with schizophrenia with or without substance use disorder: an observational study

A multinational case−control study comparing forensic and non-forensic patients with schizophrenia spectrum disorders: the EU-VIORMED project

The relationship between serum uric acid levels and severity of addiction in individuals with substance use disorders

Contact Info

Product

Resources

About