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Violent behaviour in early psychosis patients: Can we identify clinical risk profiles?
Author(s) -
Moulin Valerie,
Palix Julie,
Golay Philippe,
Dumais Alexandre,
Gholamrezaee Mohammad Mehdi,
Azzola Agathe,
Baumann Philipp S.,
Alameda Luis,
Conus Philippe
Publication year - 2019
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12512
Subject(s) - hostility , impulsivity , psychosis , psychology , clinical psychology , intervention (counseling) , psychological intervention , psychiatry , medicine
Aims The objective of this study is to explore, within a sample of early psychosis patients (EPP), if subgroups regarding rate of violent behaviour (VB) against others can be identified on the basis of dynamic risk factors (treatment modifiable characteristics). Methods In a sample of 265 EPP, treated at the Treatment and Early Intervention in Psychosis Program in Lausanne, we conducted a latent‐class analysis on the basis of the main dynamic VB risk factors (substance use disorder [SUD], positive symptoms, insight, and impulsivity). VB were restricted to “serious violence” and were assessed through patients self‐report, interview with relatives or forensic services and with a standardized instrument. Results The analysis confirmed the heterogeneity of the sample regarding rate of VB. Patients could be stratified within 4 subgroups, 3 of which were at increased risk of VB. The two groups with the highest rates of VB displayed specific clinical profiles. The first one was characterized by high levels of impulsivity, hostility, positive symptoms and SUD, and the second, by low level of insight and low social functioning. These patterns suggest that significant difficulties in social interaction may contribute to the emergence of aggressive reactions against others. Conclusions Identification of EPP at increased risk of VB seems possible on the basis of dynamic risk factors. If confirmed prospectively, this could pave the way to the development of preventive strategies and specific interventions.