Risk factors for violent behaviour before and after the onset of schizophrenia spectrum disorder: A naturalistic case-control study in the Netherlands

Genetic Risk and Outcome of Psychosis (GROUP) investigators

doi:10.1016/j.schres.2023.10.008

Risk factors for violent behaviour before and after the onset of schizophrenia spectrum disorder: A naturalistic case-control study in the Netherlands

Genetic Risk and Outcome of Psychosis (GROUP) investigators

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Risk factors for violent behaviour may differ depending on whether this begins before (VBO) or after (VAO) the onset of schizophrenia spectrum disorder. However, previous studies have been limited by selective samples of forensic patients and crude outcome measures. Methods: The sample consisted of 1013 patients with schizophrenia spectrum disorders recruited from various treatment settings across the Netherlands. Putative risk factors and outcomes were measured with standardised instruments. We used logistic regression models to compare patients with VBO (n = 48), patients with VAO (n = 130) and nonviolent (NV) patients (n = 708) on each risk factor, adjusting for sex and age. Results: Patients with VBO more often lived in a socially disorganised neighbourhood than NV patients (adjusted odds ratio [aOR] 3.3, 95 % confidence interval [CI] 1.3–8.0) and patients with VAO (aOR 3.3, 95 % CI 1.1–9.6). Clinical risk factors were more prevalent in patients with VAO than in NV patients, with substance misuse (aOR 1.5, 95 % CI 1.0–2.3), impairments in executive functions (aOR 1.6, 95 % CI 1.0–2.4), poor impulse control (aOR 2.4, 9 % CI 1.5–3.6), delusions (aOR 1.5, 95 % CI 1.1–2.3) and lack of illness insight (aOR 1.5, 95 % CI 1.0–2.2) reaching statistical significance. Patients with VBO were also more likely to have poor impulse control than NV patients (aOR 2.6, 95 % CI 1.3–5.1). Conclusion: Strategies to predict and prevent violence in schizophrenia spectrum disorders should distinguish between VBO and VAO.

Original language	English
Pages (from-to)	1-7
Number of pages	7
Journal	Schizophrenia Research
Volume	262
Early online date	28 Oct 2023
DOIs	https://doi.org/10.1016/j.schres.2023.10.008
Publication status	Published - Dec 2023

Bibliographical note

Funding Information:
The GROUP project was supported by the Geestkracht program of the Netherlands Organisation for Health Research and Development (grant number 10-000-1001 ) and matching funds from the coordinating university medical centres (i.e., Academic Medical Centre, Maastricht University Medical Centre+, University Medical Centre Groningen, University Medical Centre Utrecht), affiliated mental healthcare institutions (i.e., Altrecht, Arkin, Delta, Dimence, Dijk en Duin, Erasmus University Medical Centre, GGNet, GGZ Breburg, GGZ Centraal, GGZ Drenthe, GGZ Eindhoven en De Kempen, GGZ Friesland, GGZ inGeest, Mondriaan, GGZ Noord-Holland-Noord, GGZ Oost-Brabant, GGZ Overpelt, GGZ Rivierduinen, Lentis, Mediant GGZ, Met GGZ, Parnassia Psycho-Medical Centre, Psychiatric Centre Ziekeren, Psychiatric Hospital Sancta Maria, Public Centre for Mental Health Rekem, Collaborative Antwerp Psychiatric Research Institute, Vincent van Gogh voor Geestelijke Gezondheid, Virenze Riagg, University Psychiatric Centre Sint Jozef, Yulius, Zuyderland GGZ), and participating pharmaceutical companies (i.e., Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag). The funders had no role in study design, data collection or analysis, decision to publish, or the preparation of the manuscript.

Publisher Copyright:
© 2023 The Authors

Funding

The GROUP project was supported by the Geestkracht program of the Netherlands Organisation for Health Research and Development (grant number 10-000-1001 ) and matching funds from the coordinating university medical centres (i.e., Academic Medical Centre, Maastricht University Medical Centre+, University Medical Centre Groningen, University Medical Centre Utrecht), affiliated mental healthcare institutions (i.e., Altrecht, Arkin, Delta, Dimence, Dijk en Duin, Erasmus University Medical Centre, GGNet, GGZ Breburg, GGZ Centraal, GGZ Drenthe, GGZ Eindhoven en De Kempen, GGZ Friesland, GGZ inGeest, Mondriaan, GGZ Noord-Holland-Noord, GGZ Oost-Brabant, GGZ Overpelt, GGZ Rivierduinen, Lentis, Mediant GGZ, Met GGZ, Parnassia Psycho-Medical Centre, Psychiatric Centre Ziekeren, Psychiatric Hospital Sancta Maria, Public Centre for Mental Health Rekem, Collaborative Antwerp Psychiatric Research Institute, Vincent van Gogh voor Geestelijke Gezondheid, Virenze Riagg, University Psychiatric Centre Sint Jozef, Yulius, Zuyderland GGZ), and participating pharmaceutical companies (i.e., Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag). The funders had no role in study design, data collection or analysis, decision to publish, or the preparation of the manuscript.

Keywords

Aggression
Onset
Psychosis
Schizophrenia
Typology
Violence

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10.1016/j.schres.2023.10.008

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@article{e988031b39a64d3a8baa1c7f750951f6,

title = "Risk factors for violent behaviour before and after the onset of schizophrenia spectrum disorder: A naturalistic case-control study in the Netherlands",

abstract = "Background: Risk factors for violent behaviour may differ depending on whether this begins before (VBO) or after (VAO) the onset of schizophrenia spectrum disorder. However, previous studies have been limited by selective samples of forensic patients and crude outcome measures. Methods: The sample consisted of 1013 patients with schizophrenia spectrum disorders recruited from various treatment settings across the Netherlands. Putative risk factors and outcomes were measured with standardised instruments. We used logistic regression models to compare patients with VBO (n = 48), patients with VAO (n = 130) and nonviolent (NV) patients (n = 708) on each risk factor, adjusting for sex and age. Results: Patients with VBO more often lived in a socially disorganised neighbourhood than NV patients (adjusted odds ratio [aOR] 3.3, 95 % confidence interval [CI] 1.3–8.0) and patients with VAO (aOR 3.3, 95 % CI 1.1–9.6). Clinical risk factors were more prevalent in patients with VAO than in NV patients, with substance misuse (aOR 1.5, 95 % CI 1.0–2.3), impairments in executive functions (aOR 1.6, 95 % CI 1.0–2.4), poor impulse control (aOR 2.4, 9 % CI 1.5–3.6), delusions (aOR 1.5, 95 % CI 1.1–2.3) and lack of illness insight (aOR 1.5, 95 % CI 1.0–2.2) reaching statistical significance. Patients with VBO were also more likely to have poor impulse control than NV patients (aOR 2.6, 95 % CI 1.3–5.1). Conclusion: Strategies to predict and prevent violence in schizophrenia spectrum disorders should distinguish between VBO and VAO.",

keywords = "Aggression, Onset, Psychosis, Schizophrenia, Typology, Violence",

author = "Jelle Lamsma and Harte, {Joke M.} and Wiepke Cahn and {Genetic Risk and Outcome of Psychosis (GROUP) investigators}",

note = "Funding Information: The GROUP project was supported by the Geestkracht program of the Netherlands Organisation for Health Research and Development (grant number 10-000-1001 ) and matching funds from the coordinating university medical centres (i.e., Academic Medical Centre, Maastricht University Medical Centre+, University Medical Centre Groningen, University Medical Centre Utrecht), affiliated mental healthcare institutions (i.e., Altrecht, Arkin, Delta, Dimence, Dijk en Duin, Erasmus University Medical Centre, GGNet, GGZ Breburg, GGZ Centraal, GGZ Drenthe, GGZ Eindhoven en De Kempen, GGZ Friesland, GGZ inGeest, Mondriaan, GGZ Noord-Holland-Noord, GGZ Oost-Brabant, GGZ Overpelt, GGZ Rivierduinen, Lentis, Mediant GGZ, Met GGZ, Parnassia Psycho-Medical Centre, Psychiatric Centre Ziekeren, Psychiatric Hospital Sancta Maria, Public Centre for Mental Health Rekem, Collaborative Antwerp Psychiatric Research Institute, Vincent van Gogh voor Geestelijke Gezondheid, Virenze Riagg, University Psychiatric Centre Sint Jozef, Yulius, Zuyderland GGZ), and participating pharmaceutical companies (i.e., Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag). The funders had no role in study design, data collection or analysis, decision to publish, or the preparation of the manuscript. Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = dec,

doi = "10.1016/j.schres.2023.10.008",

language = "English",

volume = "262",

pages = "1--7",

journal = "Schizophrenia Research",

issn = "0920-9964",

publisher = "Elsevier B.V.",

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T1 - Risk factors for violent behaviour before and after the onset of schizophrenia spectrum disorder

T2 - A naturalistic case-control study in the Netherlands

AU - Lamsma, Jelle

AU - Harte, Joke M.

AU - Cahn, Wiepke

AU - Genetic Risk and Outcome of Psychosis (GROUP) investigators

N1 - Funding Information: The GROUP project was supported by the Geestkracht program of the Netherlands Organisation for Health Research and Development (grant number 10-000-1001 ) and matching funds from the coordinating university medical centres (i.e., Academic Medical Centre, Maastricht University Medical Centre+, University Medical Centre Groningen, University Medical Centre Utrecht), affiliated mental healthcare institutions (i.e., Altrecht, Arkin, Delta, Dimence, Dijk en Duin, Erasmus University Medical Centre, GGNet, GGZ Breburg, GGZ Centraal, GGZ Drenthe, GGZ Eindhoven en De Kempen, GGZ Friesland, GGZ inGeest, Mondriaan, GGZ Noord-Holland-Noord, GGZ Oost-Brabant, GGZ Overpelt, GGZ Rivierduinen, Lentis, Mediant GGZ, Met GGZ, Parnassia Psycho-Medical Centre, Psychiatric Centre Ziekeren, Psychiatric Hospital Sancta Maria, Public Centre for Mental Health Rekem, Collaborative Antwerp Psychiatric Research Institute, Vincent van Gogh voor Geestelijke Gezondheid, Virenze Riagg, University Psychiatric Centre Sint Jozef, Yulius, Zuyderland GGZ), and participating pharmaceutical companies (i.e., Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag). The funders had no role in study design, data collection or analysis, decision to publish, or the preparation of the manuscript. Publisher Copyright: © 2023 The Authors

PY - 2023/12

Y1 - 2023/12

N2 - Background: Risk factors for violent behaviour may differ depending on whether this begins before (VBO) or after (VAO) the onset of schizophrenia spectrum disorder. However, previous studies have been limited by selective samples of forensic patients and crude outcome measures. Methods: The sample consisted of 1013 patients with schizophrenia spectrum disorders recruited from various treatment settings across the Netherlands. Putative risk factors and outcomes were measured with standardised instruments. We used logistic regression models to compare patients with VBO (n = 48), patients with VAO (n = 130) and nonviolent (NV) patients (n = 708) on each risk factor, adjusting for sex and age. Results: Patients with VBO more often lived in a socially disorganised neighbourhood than NV patients (adjusted odds ratio [aOR] 3.3, 95 % confidence interval [CI] 1.3–8.0) and patients with VAO (aOR 3.3, 95 % CI 1.1–9.6). Clinical risk factors were more prevalent in patients with VAO than in NV patients, with substance misuse (aOR 1.5, 95 % CI 1.0–2.3), impairments in executive functions (aOR 1.6, 95 % CI 1.0–2.4), poor impulse control (aOR 2.4, 9 % CI 1.5–3.6), delusions (aOR 1.5, 95 % CI 1.1–2.3) and lack of illness insight (aOR 1.5, 95 % CI 1.0–2.2) reaching statistical significance. Patients with VBO were also more likely to have poor impulse control than NV patients (aOR 2.6, 95 % CI 1.3–5.1). Conclusion: Strategies to predict and prevent violence in schizophrenia spectrum disorders should distinguish between VBO and VAO.

AB - Background: Risk factors for violent behaviour may differ depending on whether this begins before (VBO) or after (VAO) the onset of schizophrenia spectrum disorder. However, previous studies have been limited by selective samples of forensic patients and crude outcome measures. Methods: The sample consisted of 1013 patients with schizophrenia spectrum disorders recruited from various treatment settings across the Netherlands. Putative risk factors and outcomes were measured with standardised instruments. We used logistic regression models to compare patients with VBO (n = 48), patients with VAO (n = 130) and nonviolent (NV) patients (n = 708) on each risk factor, adjusting for sex and age. Results: Patients with VBO more often lived in a socially disorganised neighbourhood than NV patients (adjusted odds ratio [aOR] 3.3, 95 % confidence interval [CI] 1.3–8.0) and patients with VAO (aOR 3.3, 95 % CI 1.1–9.6). Clinical risk factors were more prevalent in patients with VAO than in NV patients, with substance misuse (aOR 1.5, 95 % CI 1.0–2.3), impairments in executive functions (aOR 1.6, 95 % CI 1.0–2.4), poor impulse control (aOR 2.4, 9 % CI 1.5–3.6), delusions (aOR 1.5, 95 % CI 1.1–2.3) and lack of illness insight (aOR 1.5, 95 % CI 1.0–2.2) reaching statistical significance. Patients with VBO were also more likely to have poor impulse control than NV patients (aOR 2.6, 95 % CI 1.3–5.1). Conclusion: Strategies to predict and prevent violence in schizophrenia spectrum disorders should distinguish between VBO and VAO.

KW - Aggression

KW - Onset

KW - Psychosis

KW - Schizophrenia

KW - Typology

KW - Violence

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VL - 262

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JO - Schizophrenia Research

JF - Schizophrenia Research

ER -

Risk factors for violent behaviour before and after the onset of schizophrenia spectrum disorder: A naturalistic case-control study in the Netherlands

Abstract

Bibliographical note

Funding

Keywords

Access to Document

Persistent URL (handle)

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