Violence in Male Patients with Schizophrenia: Risk Markers in a South African Population

Koen, Liezl; Kinnear, Craig; Corfield, Valerie A.; Emsley, Robin; Jordaan, Esmè; Keyter, N.; Moolman‐Smook, Johanna C.; Stein, Dan J.; Niehaus, Dana

doi:10.1080/j.1440-1614.2004.01338.x

Cited by 35 publications

(19 citation statements)

References 43 publications

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“…Seven samples used the overt aggression scale (OAS) (Yudofsky et al, 1986) to classify patients with schizophrenia as violent or non-violent, whereas five samples used the history of violence either lifetime or two weeks prior to admission. Strous et al (1997) used the risk assessment for dangerousness scale (Volavka, 1995) and Koen et al (2004) used the Corrigan agitated behavior scale and the PANSS (Kay et al, 1989) excited factor. The frequency of violent schizophrenia patients in each sample ranged from 23% to 77%.…”

Section: Resultsmentioning

confidence: 99%

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The COMT Met158 allele and violence in schizophrenia: A meta-analysis

Bhakta¹,

Zhang²,

Malhotra³

2012

Schizophrenia Research

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Background The Met158 allele of catechol-O-methyl transferase (COMT) gene is associated with increased levels of catecholamines in the prefrontal cortex and may increase the likelihood of aggressiveness. We conducted a meta-analysis to test the hypothesis that the Met158 allele of the COMT gene is associated with aggressive and violent behavior in schizophrenia. Methods MEDLINE search (12/31/11) yielded 14 studies examining the association of the COMT gene polymorphism (rs4680) and aggression in schizophrenia (total n=2219). Three separate analyses were conducted using a random effects model for Met allele carriers vs. Val/Val homozygotes, Met/Met homozygotes vs. Val allele carriers, and Met allele vs. Val allele, respectively. Primary outcome was frequency of patients with aggressive behavior and odds ratio (OR) was the effect size measure. Results The frequency of violent patients in the sample ranged from 20% to 75%. The pooled effect sizes for the Met homozygotes vs. Val allele carriers, Met allele carriers vs. Val homozygotes and the Met allele vs. Val allele comparisons were 1.74, 1.65 and 1.35, ps<.05, respectively, suggesting that the Met 158 allele of the COMT gene is associated with higher risk for violence in schizophrenia. Results remained significant after examining heterogeneity among samples and potential publication biases. Conclusions TheMet158 allele of the COMT gene confers a significantly increased risk for aggressive and violent behavior in schizophrenia. These data may provide basis for developing informative strategies for reducing violence in patients with schizophrenia.

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Section: Resultsmentioning

confidence: 99%

“…In contrast, Jones et al (2001) reported that Val/Val genotype was associated with greater risk for violence in patients with schizophrenia; others have found the association to be inconsistent (Liou et al, 2001; Koen et al, 2004; Zammit et al, 2004; Kim et al, 2008; Gu et al, 2009). …”

Section: Introductionmentioning

confidence: 96%

The COMT Met158 allele and violence in schizophrenia: A meta-analysis

Bhakta¹,

Zhang²,

Malhotra³

2012

Schizophrenia Research

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“…Disturbed behavior (violence, aggression) has also been previously linked with amphetamine use (Dawe, Davis, Lapworth, & McKetin, 2009). However, the research surrounding cannabis use and disturbed behavior has been mixed, and many confounding factors have been identified, leading to uncertainty about the direct impact that cannabis has on disturbed behavior (Koen et al, 2004;Swanson et al, 2006). The unique aspect of this study was the ongoing monitoring of symptom profile across time.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the symptoms and short-term clinical course in inpatients with substance-induced psychosis and primary psychosis

Dawe

Geppert

Occhipinti

et al. 2011

Journal of Substance Abuse Treatment

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“…Advocates of such association [7][8][9][10] list delusional theme, chronicity, and dimensional severity among primary risk factors. It has been repeatedly reported that delusions of guilt, persecution, sinfulness, punishment, control and reference are more likely to coincide with threat of suicide or aggression than other types of delusions [2,[6][7][8][9][11][12][13]. It is argued here that delusional content can be indicative of the likelihood of (auto-)aggressiveness.…”

Section: Introductionmentioning

confidence: 85%

“Ego-Dystonic” Delusions as a Predictor of Dangerous Behavior

2011

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This paper aims to report a possible warning sign for dangerous behavior in delusional psychotic patients. We demonstrate an association between aggressive or auto-aggressive ideation and "ego-dystonic" grandiose delusions, where the patient believes to possess unique qualities but finds them unbearable. The study is based on the sample of seven interviews with five psychotic in-patients at the Kfar Shaul Mental Health Center, Jerusalem, Israel. All patients experienced an acute psychotic episode, and committed acts of aggression or suicidality. The research method is narrative analysis of semi-structured interviews. Patients report ideas of grandiose self-identification with deities, Biblical figures or celebrities, yet report their reluctance to be in these high positions due to feelings of unworthiness, withdrawal, and social isolation. Resulting frustration arguably leads to aggressive and suicidal ideation or actions. Contrary to the established view, grandiose delusions are not free of association with (auto-)aggression. The patient's ego-dystonic attitude towards his/her delusional identity may serve as the warning sign for dangerous behavior and, as such, should be searched for and recognized by the mental health professionals.

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Violence in Male Patients with Schizophrenia: Risk Markers in a South African Population

Cited by 35 publications

References 43 publications

The COMT Met158 allele and violence in schizophrenia: A meta-analysis

The COMT Met158 allele and violence in schizophrenia: A meta-analysis

A comparison of the symptoms and short-term clinical course in inpatients with substance-induced psychosis and primary psychosis

“Ego-Dystonic” Delusions as a Predictor of Dangerous Behavior

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