TY - JOUR
T1 - Aggressive Behavior, Hostility, and Associated Care Needs in Patients With Psychotic Disorders
T2 - A 6-Year Follow-Up Study
AU - Faay, Margo D. M.
AU - van Os, Jim
AU - van Amelsvoort, Therese
AU - Bartels-Velthuis, Agna A.
AU - Bruggeman, Richard
AU - Cahn, Wiepke
AU - de Haan, Lieuwe
AU - Schirmbeck, Frederike
AU - Simons, Claudia J. P.
AU - Genetic Risk and Outcome of Psychosis (GROUP) Investigators
N1 - Publisher Copyright:
© Copyright © 2020 Faay, van Os and the Genetic Risk and Outcome of Psychosis (GROUP) Investigators.
PY - 2020/1/8
Y1 - 2020/1/8
N2 - Background: Hostility and aggressive behavior in patients with psychotic disorders are associated with demographic and clinical risk factors, as well as with childhood adversity and neglect. Care needs are an essential concept in clinical practice; care needs in the domain of safety for others reflect the actual problem the patient has. Hostility, aggressive behavior, and associated care needs, however, are often studied in retrospect. Method: In a sample of 1,119 patients with non-affective psychotic disorders, who were interviewed three times over a period of 6 years, we calculated the incidence of hostility, self-reported maltreatment to others and care needs associated with safety for other people (safety-to-others). Regression analysis was used to analyze the association between these outcomes and risk factors. The population attributable fraction (PAF) was used to calculate the proportion of the outcome that could potentially be prevented if previous expressions of adverse behavior were eliminated. Results: The yearly incidence of hostility was 2.8%, for safety-to-others 0.8% and for maltreatment this was 1.8%. Safety-to-others was associated with previous hostility and vice versa, but, assuming causality, only 18% of the safety-to-others needs was attributable to previous hostility while 26% was attributable to impulsivity. Hostility, maltreatment and safety-to-others were all associated with number of unmet needs, suicidal ideation and male sex. Hostility and maltreatment, but not safety-to-others, were associated with childhood adversity. Neither safety-to-others, maltreatment nor hostility were associated with premorbid adjustment problems. Conclusion: The incidence of hostility, self-reported aggressive behaviors, and associated care needs is low and linked to childhood adversity. Known risk factors for prevalence also apply to incidence and for care needs associated with safety for other people. Clinical symptoms can index aggressive behaviors years later, providing clinicians with some opportunity for preventing future incidents.
AB - Background: Hostility and aggressive behavior in patients with psychotic disorders are associated with demographic and clinical risk factors, as well as with childhood adversity and neglect. Care needs are an essential concept in clinical practice; care needs in the domain of safety for others reflect the actual problem the patient has. Hostility, aggressive behavior, and associated care needs, however, are often studied in retrospect. Method: In a sample of 1,119 patients with non-affective psychotic disorders, who were interviewed three times over a period of 6 years, we calculated the incidence of hostility, self-reported maltreatment to others and care needs associated with safety for other people (safety-to-others). Regression analysis was used to analyze the association between these outcomes and risk factors. The population attributable fraction (PAF) was used to calculate the proportion of the outcome that could potentially be prevented if previous expressions of adverse behavior were eliminated. Results: The yearly incidence of hostility was 2.8%, for safety-to-others 0.8% and for maltreatment this was 1.8%. Safety-to-others was associated with previous hostility and vice versa, but, assuming causality, only 18% of the safety-to-others needs was attributable to previous hostility while 26% was attributable to impulsivity. Hostility, maltreatment and safety-to-others were all associated with number of unmet needs, suicidal ideation and male sex. Hostility and maltreatment, but not safety-to-others, were associated with childhood adversity. Neither safety-to-others, maltreatment nor hostility were associated with premorbid adjustment problems. Conclusion: The incidence of hostility, self-reported aggressive behaviors, and associated care needs is low and linked to childhood adversity. Known risk factors for prevalence also apply to incidence and for care needs associated with safety for other people. Clinical symptoms can index aggressive behaviors years later, providing clinicians with some opportunity for preventing future incidents.
KW - aggression
KW - violence
KW - needs assessment
KW - psychotic disorders
KW - incidence
KW - risk factors
KW - INTERVENTION EFFECTIVENESS CATIE
KW - CLINICAL ANTIPSYCHOTIC TRIALS
KW - VIOLENT BEHAVIOR
KW - CHILDHOOD TRAUMA
KW - PREMORBID ADJUSTMENT
KW - SCHIZOPHRENIA
KW - RELIABILITY
KW - VALIDITY
KW - PEOPLE
KW - INSTRUMENT
U2 - 10.3389/fpsyt.2019.00934
DO - 10.3389/fpsyt.2019.00934
M3 - Article
C2 - 31998154
SN - 1664-0640
VL - 10
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 934
ER -