Clinical and neurodevelopmental correlates of aggression in early psychosis.
Clinical and neurodevelopmental correlates of aggression in early psychosis.
复制标题
早期精神病中攻击行为的临床和神经发育相关性。
DOI：
10.1016/j.schres.2019.07.045
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发表时间：
2019
影响因子：
4.5
通讯作者：
Niendam,Tara
中科院分区：
文献类型：
--
作者：
Lopez-Garcia,Pilar;Ashby,Stefania;Patel,Pooja;Pierce,KatherineM;Meyer,Monet;Rosenthal,Adi;Titone,Madison;Carter,Cameron;Niendam,Tara
虽然在一般人群中，精神疾病只占攻击行为的4%，但攻击行为和精神障碍之间仍然存在一定的联系，特别是在疾病的早期阶段。然而，人们对与这种风险增加有关的具体因素知之甚少。目的探讨首发精神病患者（FEP）攻击行为的发生率、特征及危险因素。方法对从门诊早期精神病诊所招募的449例FEP患者进行回顾性分析。攻击行为和临床信息是根据基线和随访6个 月后收集的数据的图表审查收集的信息进行评分的。结果FEP患者攻击行为发生率为54.3%。攻击性行为与较高的出生并发症、神经发育迟缓、学习困难、酒精使用障碍和临床贫困症状的发生率显著相关。除攻击行为外，16.7%的FEP患者表现出自杀意念或行为，11.4%表现出非自杀自伤行为（NSSIB）。与基线相比，在6 个月的随访中，攻击行为几乎完全消失。结论早期精神病患者在就诊前有较高的攻击行为和自杀行为。神经发育障碍、酒精使用障碍和贫穷症状与早期精神病中较高的攻击风险相关。参与早期精神病专科护理导致攻击行为的显著减少。
BackgroundAlthough mental illness accounts for only 4% of aggressive behavior in the general population, there remains a modest association between aggressive behavior and psychotic disorders, particularly in the early stages of the illness. However, little is known about the specific factors associated to this increased risk.AimsThe present study aims to assess the rates, characteristics and risk factors of aggressive behavior in first episode psychosis patients (FEP).MethodWe conducted a retrospective chart review of 449 FEP patients recruited from an outpatient early psychosis clinic. Aggressive behavior and clinical information were rated based upon information gathered from the chart review of data collected at baseline and after 6 months of follow-up.ResultsRates of aggressive behavior were 54.3% in FEP patients. Aggressive behavior was significantly associated with higher rates of history of birth complications, neurodevelopmental delays, learning difficulties, alcohol use disorders, and the clinical domain of poverty symptoms. In addition to aggressive behavior, 16.7% of FEP patients exhibited suicidal ideation or behaviors and 11.4% exhibited non-suicidal self-injurious behavior (NSSIB). In contrast to baseline, aggressive behaviors at 6 months follow up were almost entirely absent.ConclusionsPatients at early stages of psychosis have high rates of aggressive and suicidal behavior prior to contact with clinical services. Neurodevelopmental adversities, alcohol use disorders and poverty symptoms are associated to higher risk of aggression in early psychosis. Participation in early psychosis specialty care resulted in a dramatic reduction in aggressive behavior.