Multifactor nature of aggressive behavior in individuals with schizophrenia spectrum disorders

Multifactor nature of aggressive behavior in individuals with schizophrenia spectrum disorders

 

Authors

 

Makushkina O.A.

FSBI “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

Leurda E.V.

FSBI “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

Golenkova V.A.

FSBI “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

 

https://doi.org/10.26617/1810-3111-2023-3(120)-45-54

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 3 (120):  45-54.

 

Abstract

Background. The relevance is due to the need to reveal the mechanisms and pathogenesis of heteroaggression in patients of psychiatric services to improve the accuracy of risk assessment and the effectiveness of prevention. Objective:to study the role of social, clinical and biological factors in the formation of aggressive behavior in individuals with schizophrenia spectrum disorders. Materials. An observational, comparative study was carried out based on the Federal State Budgetary Institution “V.P. Serbsky National Medical Research Center of Psychiatry and Narcology”, State Budgetary Healthcare Institution “Psychiatric Clinical Hospital No. 4 named after P.B. Gannushkin MHD”, State Budgetary Healthcare Institution “Psychiatric Clinical Hospital No. 5 MHD”. Patients (n=141) aged 18-60 years (mean age – 39±10 years), who were diagnosed with schizophrenia spectrum disorders (F20, F21, F25) according to ICD-10, were examined. From the study sample, 2 groups of patients were formed: the main group (n=70) – with persistent aggressive behavior, who committed violent offenses; comparison group (n=71) – without criminal prosecution and manifestations of aggressive behavior. Methods: clinical-psychopathological, psychometric (using the “Positive and Negative Syndromes Scale”, the “Structured Risk Assessment of Dangerous Behavior” technique), laboratory (determination of biogenic amines in urine and hormone levels in the blood). Collection, correction, systematization of initial information and visualization of the findings were carried out in Microsoft Office Excel 2019. Statistical analysis was carried out using the IBM SPSS Statistics v.26 program. Results. Patients of the main group were more often brought-up in single-parent families, with a hypo-protective parenting style, cruelty of parents, most of them were not married, did not have children, lived with relatives, had a low level of education and a disability group, were not employed, were in a difficult financial situation, were distinguished by conflict with heteroaggression, had a hereditary story of parental alcohol addiction, emotionally unstable, excitable traits in premorbid period, a diagnosis of paranoid schizophrenia with comorbid dependence on alcohol/drugs, a continuous type of schizophrenia, characterized by a decrease in self-control, critical and prognostic abilities; the predominance of affective-volitional disorders with explosiveness, dysphoria, hostility and opposition, paradoxical emotional reactions and impulsiveness of actions, violated the regime of a psychiatric hospital, did not adhere to recommended psycho-pharmacotherapy, and did not visit a local psychiatrist. Using mathematical and statistical methods, statistically significant risk factors for aggressive behavior were identified: pathological parenting style (hypo-protective, cruel attitude), abnormal premorbid personal traits (emotionally unstable, excitable structure), the presence of comorbid addiction to psychoactive substances, conflicting intrafamily relationships, financial disadvantage, non-adherence to therapy. Clinical prerequisites for their formation were: the continuous course of the disease, pronounced impairments of self-control, critical and prognostic abilities, the predominance of emotional, affective-volitional disorders with explosiveness, dysphoria, and impulsiveness of actions. It was found that among respondents in the main group, the levels of serotonin, dopamine and cortisol were statistically significantly lower, and the level of testosterone, the ratio of testosterone and cortisol was higher than in the comparison group (p<0.05). A negative correlation was revealed between the level of serotonin and the scores of the aggression subscale of the PANSS method and the scores of the SOROP method. Conclusion. The findings can be used to develop risk assessment tools and formulate effective strategies for the prevention of violent offenses by patients with schizophrenia spectrum disorders.

 

Keywords: mental disorders, aggressive behavior, violent offenses, social danger, biological psychiatry, neurotransmitters, hormones.

 

Article (pdf)

 

Contacts

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Materials  

For citation: Makushkina O.A., Leurda E.V., Golenkova V.A. Multifactor nature of aggressive behavior in individuals with schizophrenia spectrum disorders.Siberian Herald of Psychiatry and Addiction Psychiatry.2023; 3 (120): 45-54. https://doi.org/10.26617/1810-3111-2023-3(120)-45-54.

 

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