TY - JOUR
T1 - Aggression and psychopathology in treatment-resistant inpatients with schizophrenia and schizoaffective disorder
AU - Nolan, Karen A.
AU - Volavka, Jan
AU - Czobor, Pal
AU - Sheitman, Brian
AU - Lindenmayer, Jean Pierre
AU - Citrome, Leslie L.
AU - McEvoy, Joseph
AU - Lieberman, Jeffrey A.
N1 - Funding Information:
NIMH Grant (R10 MH53550) provided the principal support for this project. Additional support was provided by the UNC-Mental Health and Neuroscience Clinical Research Center (MH MH33127) and the Foundation of Hope, Raleigh North Carolina. We thank Janssen Pharmaceutica Research Foundation, Eli Lilly and Company, Novartis Pharmaceuticals Corporation, and Merck and Co., Inc. for their generous gifts of medications. Eli Lilly and Company contributed supplemental funding that covered approximately 18% of the total cost of the study. However, overall experimental design, data acquisition, statistical analyses, and interpretation of the results were implemented without any input from any of the pharmaceutical companies. Linda Kline, RN, MS, CS was the chief coordinator of the entire project.
PY - 2005/1
Y1 - 2005/1
N2 - Positive psychotic symptoms, such as threat/"control-override" delusions or command hallucinations, have been related to aggression in patients with schizophrenia. However, retrospective data collection has hampered evaluation of the direct influence of psychopathology on aggressive behavior. In this study, we monitored aggressive behavior and psychopathology prospectively and in close temporal proximity in 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder participating in a 14-week double-blind clinical trial. Aggressive behavior was rated with the overt aggression scale (OAS). Psychopathology was assessed using the positive and negative syndrome scale (PANSS). At baseline, subjects who would be aggressive during the study had higher scores on only two PANSS items: hostility and poor impulse control. During the study PANSS positive subscale scores were significantly higher in aggressive subjects. Total PANSS scores were higher within 3 days of an aggressive incident, as were positive and general psychopathology subscale scores. However, in a smaller subsample for whom PANSS ratings were available within 3 days before aggressive incidents, only scores on the PANSS positive subscale were significantly higher. These findings in chronic, treatment resistant inpatients support the view that positive symptoms may lead to aggression.
AB - Positive psychotic symptoms, such as threat/"control-override" delusions or command hallucinations, have been related to aggression in patients with schizophrenia. However, retrospective data collection has hampered evaluation of the direct influence of psychopathology on aggressive behavior. In this study, we monitored aggressive behavior and psychopathology prospectively and in close temporal proximity in 157 treatment-resistant inpatients diagnosed with chronic schizophrenia or schizoaffective disorder participating in a 14-week double-blind clinical trial. Aggressive behavior was rated with the overt aggression scale (OAS). Psychopathology was assessed using the positive and negative syndrome scale (PANSS). At baseline, subjects who would be aggressive during the study had higher scores on only two PANSS items: hostility and poor impulse control. During the study PANSS positive subscale scores were significantly higher in aggressive subjects. Total PANSS scores were higher within 3 days of an aggressive incident, as were positive and general psychopathology subscale scores. However, in a smaller subsample for whom PANSS ratings were available within 3 days before aggressive incidents, only scores on the PANSS positive subscale were significantly higher. These findings in chronic, treatment resistant inpatients support the view that positive symptoms may lead to aggression.
KW - Aggression
KW - Psychopathology
KW - Schizophrenia
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U2 - 10.1016/j.jpsychires.2004.04.010
DO - 10.1016/j.jpsychires.2004.04.010
M3 - Article
C2 - 15504429
AN - SCOPUS:7044222806
SN - 0022-3956
VL - 39
SP - 109
EP - 115
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
IS - 1
ER -