Clinical and neurodevelopmental correlates of aggression in early psychosis.
Adolescent
Adult
Aggression
/ physiology
Alcoholism
/ epidemiology
Comorbidity
Female
Follow-Up Studies
Humans
Male
Neurodevelopmental Disorders
/ epidemiology
Poverty
/ statistics & numerical data
Psychotic Disorders
/ epidemiology
Retrospective Studies
Risk Factors
Self-Injurious Behavior
/ epidemiology
Suicidal Ideation
Young Adult
Aggression
Early psychosis
First episode psychosis
Neurodevelopment
Self-harm
Journal
Schizophrenia research
ISSN: 1573-2509
Titre abrégé: Schizophr Res
Pays: Netherlands
ID NLM: 8804207
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
02
11
2018
revised:
10
03
2019
accepted:
28
07
2019
pubmed:
8
8
2019
medline:
6
10
2020
entrez:
8
8
2019
Statut:
ppublish
Résumé
Although mental illness accounts for only 4% of aggressive behavior in the general population, there remains a modest association between aggressive behavior and psychotic disorders, particularly in the early stages of the illness. However, little is known about the specific factors associated to this increased risk. The present study aims to assess the rates, characteristics and risk factors of aggressive behavior in first episode psychosis patients (FEP). We conducted a retrospective chart review of 449 FEP patients recruited from an outpatient early psychosis clinic. Aggressive behavior and clinical information were rated based upon information gathered from the chart review of data collected at baseline and after 6 months of follow-up. Rates of aggressive behavior were 54.3% in FEP patients. Aggressive behavior was significantly associated with higher rates of history of birth complications, neurodevelopmental delays, learning difficulties, alcohol use disorders, and the clinical domain of poverty symptoms. In addition to aggressive behavior, 16.7% of FEP patients exhibited suicidal ideation or behaviors and 11.4% exhibited non-suicidal self-injurious behavior (NSSIB). In contrast to baseline, aggressive behaviors at 6 months follow up were almost entirely absent. Patients at early stages of psychosis have high rates of aggressive and suicidal behavior prior to contact with clinical services. Neurodevelopmental adversities, alcohol use disorders and poverty symptoms are associated to higher risk of aggression in early psychosis. Participation in early psychosis specialty care resulted in a dramatic reduction in aggressive behavior.
Sections du résumé
BACKGROUND
Although mental illness accounts for only 4% of aggressive behavior in the general population, there remains a modest association between aggressive behavior and psychotic disorders, particularly in the early stages of the illness. However, little is known about the specific factors associated to this increased risk.
AIMS
The present study aims to assess the rates, characteristics and risk factors of aggressive behavior in first episode psychosis patients (FEP).
METHOD
We conducted a retrospective chart review of 449 FEP patients recruited from an outpatient early psychosis clinic. Aggressive behavior and clinical information were rated based upon information gathered from the chart review of data collected at baseline and after 6 months of follow-up.
RESULTS
Rates of aggressive behavior were 54.3% in FEP patients. Aggressive behavior was significantly associated with higher rates of history of birth complications, neurodevelopmental delays, learning difficulties, alcohol use disorders, and the clinical domain of poverty symptoms. In addition to aggressive behavior, 16.7% of FEP patients exhibited suicidal ideation or behaviors and 11.4% exhibited non-suicidal self-injurious behavior (NSSIB). In contrast to baseline, aggressive behaviors at 6 months follow up were almost entirely absent.
CONCLUSIONS
Patients at early stages of psychosis have high rates of aggressive and suicidal behavior prior to contact with clinical services. Neurodevelopmental adversities, alcohol use disorders and poverty symptoms are associated to higher risk of aggression in early psychosis. Participation in early psychosis specialty care resulted in a dramatic reduction in aggressive behavior.
Identifiants
pubmed: 31387826
pii: S0920-9964(19)30325-1
doi: 10.1016/j.schres.2019.07.045
pmc: PMC7259809
mid: NIHMS1579381
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
171-176Subventions
Organisme : NICHD NIH HHS
ID : T32 HD091059
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.
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