Violence risk factors common in patients at ultra-high risk for psychosis
MedWire News: Young adults at ultra-high risk for developing psychosis show a high prevalence of risk factors for violence, results from small UK study suggest.
Writing in Early Intervention in Psychiatry, Paul Hutton (University of Manchester) and colleagues explain that although risk factors for violence have been studied extensively in patients with established psychosis, "there is little data available on the prevalence of violence risk factors in people at ultra-high risk of developing psychosis."
They add: "Further research is required, particularly given the recent publication of a paper arguing for the extension of compulsory treatment powers to this group, based on the premise that 'psychosis is an inherently dangerous condition'."
The team therefore studied 34 patients deemed to be at ultra-high risk for developing psychosis according to Comprehensive Assessment of At-Risk Mental States criteria.
All of the participants were assessed for violence risk factors, including: previous convictions (violence-related); history of violent behavior; expressions of concern from relatives, carers, and others regarding risk for violence; current violent ideation or plans; current behavior suggesting ongoing risk for violence; and clinician global judgments of overall risk to others.
They were also assessed for demographic and clinical characteristics, as well as jealousy, suspiciousness, irritability, and anger.
The researchers found that 29.4% of the patients had previous convictions that involved violence to others, 38.2% reported engaging in actual or attempted violent assaults, and 26.5% were judged by their clinician to be displaying behavior that suggested at least a low current risk for violence.
Furthermore, 79.4% of patients were judged by their clinician to be currently experiencing significant levels of suspiciousness, 47.1% anger, and 38.2% irritability, and 41.2% were judged to be impulsive.
In addition, 17.6% were thought to be experiencing significant levels of jealousy, and 32.4% were believed to have specific persecutory beliefs that conferred a risk for violence.
Hutton and team conclude: "There was a high prevalence of violence risk factors in this small sample.
"Further research with larger samples and better methodology is urgently required to investigate risk of violence in this group and determine the contribution, if any, of subclinical psychotic symptoms."
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By Mark Cowen