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Aggressive behaviour at first contact with services: findings from the AESOP First Episode Psychosis Study

Published online by Cambridge University Press:  03 October 2006

K. DEAN
Affiliation:
Institute of Psychiatry, Kings College London, UK
E. WALSH
Affiliation:
Institute of Psychiatry, Kings College London, UK
C. MORGAN
Affiliation:
Institute of Psychiatry, Kings College London, UK
A. DEMJAHA
Affiliation:
Institute of Psychiatry, Kings College London, UK
P. DAZZAN
Affiliation:
Institute of Psychiatry, Kings College London, UK
K. MORGAN
Affiliation:
Institute of Psychiatry, Kings College London, UK
T. LLOYD
Affiliation:
University of Nottingham, UK
P. FEARON
Affiliation:
Institute of Psychiatry, Kings College London, UK
P. B. JONES
Affiliation:
Department of Psychiatry, University of Cambridge, UK
R. M. MURRAY
Affiliation:
Institute of Psychiatry, Kings College London, UK

Abstract

Background. Aggressive behaviour is increased among those with schizophrenia but less is known about those with affective psychoses. Similarly, little is known about aggressive behaviour occurring at the onset of illness.

Method. The main reasons for presentation to services were examined among those recruited to a UK-based first episode psychosis study. The proportion of individuals presenting with aggressive behaviour was determined and these individuals were compared to those who were not aggressive on a range of variables including sociodemographic, clinical, criminal history, service contact, and symptom characteristics. Among the aggressive group, those who were physically violent were distinguished from those who were not violent but who were still perceived to present a risk of violence to others.

Results. Almost 40% (n=194) of the sample were aggressive at first contact with services; approximately half of these were physically violent (n=103). Younger age, African-Caribbean ethnicity and a history of previous violent offending were independently associated with aggression. Aggressive behaviour was associated with a diagnosis of mania and individual manic symptoms were also associated with aggression both for the whole sample and for those with schizophrenia. Factors differentiating violent from non-violent aggressive patients included male gender, lower social class and past violent offending.

Conclusions. Aggressive behaviour is not an uncommon feature in those presenting with first episode psychosis. Sociodemographic and past offending factors are associated with aggression and further differentiate those presenting with more serious violence. A diagnosis of mania and the presence of manic symptoms are associated with aggression.

Type
Original Article
Copyright
2007 Cambridge University Press

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