A method for assessing the risk of socially dangerous aggressive behavior in persons with severe mental disorders

A method for assessing the risk of socially dangerous aggressive behavior in persons with severe mental disorders

 

Authors

 

O.A. Makushkina

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

E.V. Leurda

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/10.26617/1810-3111-2023-2(119)-5-15

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 2 (119):  5-15.

 

Abstract

Background. The tendency to aggression is a factor contributing to the social danger of persons with mental disorders. Existing approaches and methods make it possible to assess predominantly clinical-psychopathological, anamnestic and social parameters that affect the likelihood of committing socially dangerous acts. Tools for assessing the likelihood of aggression based on biological predictors are currently not available. Objective:development of a technology for determining the risk of socially dangerous aggressive behavior in persons with severe mental disorders with the assessment of biological indicators. Materials and Methods. The technology was developed based on the results of a survey of 219 respondents diagnosed with a severe mental disorder (ICD-10 codes F00-09, F20-29, F70-72). The main group (n=105) included patients with persistent aggressive behavior who committed violent offences; comparison group (n=114) ‒ patients with law-abiding behavior. Results. With the help of mathematical and statistical tools, a Method for assessing the risk of socially dangerous aggressive behavior in persons with severe mental disorders was developed. The method consists in the complex application of the laboratory research method and psychometry. At the first stage, urine and blood are taken from the subject, followed by determination of the levels of serotonin in the urine and hormones ‒ cortisol and testosterone in the blood. Further, based on the data obtained, the regression equation is calculated using a special formula. At the second stage, screening of potential social danger is provided according to the method of structured risk assessment of dangerous behavior (SOROP). At the third stage, based on the results of the complex application of the laboratory method of research and psychometry, a conclusion is made about the risk of the patient's aggressive behavior, the likelihood of his/her committing socially dangerous actions of a violent nature. Conclusion. The method can be used in addition to clinical assessment to improve the accuracy of predicting the likelihood of socially dangerous aggressive behavior of persons with severe mental disorders.

 

Keywords: biological psychiatry, aggressive behavior, neurotransmitters, hormones, mental disorders, heteroaggression, predictors, social danger.

 

Article (pdf)

 

Contacts

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Materials  

For citation: Makushkina O.A., Leurda E.V. A method for assessing the risk of socially dangerous aggressive behavior in persons with severe mental disorders.Siberian Herald of Psychiatry and Addiction Psychiatry.2023; 2 (119): 5-15. https://doi.org/10.26617/1810-3111-2023-2(119)-5-15

 

REFERENCES

  1. Maltseva MM. Psychopathological mechanisms of socially dangerous actions of patients with mental disorders. Handbook of Forensic Psychiatry: A Practical Guide. Moscow: URAIT Publishing House LLC, 2021: 213-226 (in Russian).
  2. Makushkina OA, Sharabidze NG, Leurda EV. Prediction of the risk of repeated socially dangerous behavior in persons with severe mental disorders. Narcology. 2022;21(6):35-43. doi: 10.25557/1682-8313.2022.06.35-43(in Russian).
  3. Wolf A, Fanshawe TR, Sariaslan A, Cornish R, Larsson H, Fazel S. Prediction of violent crime on discharge from secure psychiatric hospitals: A clinical prediction rule (FoVOx). Eur Psychiatry. 2018 Jan;47:88-93. doi: 10.1016/j.eurpsy.2017.07.011. Epub 2017 Aug 4. PMID: 29161680; PMCID: PMC5797975.
  4. Makushkina OA. Out-of-hospital prevention of socially dangerous behavior of persons with mental disorders.Extramural prevention of socially dangerous behavior of persons with mental disorders. Moscow: FSBI “V.P. Serbsky NMRC PN” of the Ministry of Health of Russia, 2022:110 (in Russian).
  5. Noland E, Strandh M, Klötz Logan F. The reconvictions of mentally disordered offenders-how, when, and where? BMC Psychiatry. 2022 Apr 13;22(1):264. doi: 10.1186/s12888-022-03912-4. PMID: 35418045; PMCID: PMC9008909.
  6. Penitentiary psychology and psychopathology: Handbook in two volumes. T.B. Dmitrieva, V.Ya. Semke, A.S. Kononets, eds. Moscow, Tomsk, Kemerovo, 2007; Volume 1: 576;Volume 1: 524(in Russian).
  7. Perez-Rodriguez MM, Bulbena-Cabré A, Bassir Nia A, Zipursky G, Goodman M, New AS. The neurobiology of borderline personality disorder. Psychiatr Clin North Am. 2018 Dec;41(4):633-650. doi: 10.1016/j.psc.2018.07.012. PMID: 30447729.
  8. Tobore TO. On the neurobiological role of oxidative stress in alcohol-induced impulsive, aggressive and suicidal behavior. Subst Use Misuse. 2019;54(14):2290-2303. doi: 10.1080/10826084.2019.1645179. Epub 2019 Aug 1. PMID: 31369300.
  9. da Cunha-Bang S, Knudsen GM. The modulatory role of serotonin on human impulsive aggression. Biol Psychiatry. 2021 Oct 1;90(7):447-457. doi: 10.1016/j.biopsych.2021.05.016. Epub 2021 May 25. PMID: 34266672.
  10. Manchia M, Comai S, Pinna M, Pinna F, Fanos V, Denovan-Wright E, Carpiniello B. Biomarkers in aggression. Adv Clin Chem. 2019;93:169-237. doi: 10.1016/bs.acc.2019.07.004. Epub 2019 Sep 11. PMID: 31655730.
  11. Cho W, Shin WS, An I, Bang M, Cho DY, Lee SH. Biological aspects of aggression and violence in schizophrenia. Clin Psychopharmacol Neurosci. 2019 Nov 20;17(4):475-486. doi: 10.9758/cpn.2019.17.4.475. PMID: 31671484; PMCID: PMC6852683.
  12. Shamrey VK, Marchenko AA, Kurasov ES. Modern approaches to objectification of diagnostics of mental disorders. Bulletin of the Russian Military Medical Academy. 2018;4(64): 38-44 (in Russian).
  13. Kogan BM, Drozdov AZ. Catecholamine neurotransmitter systems in mental disorders of addictive spectrum. Journal of Addiction Issues. 2017;(2-3):139-154 (in Russian).
  14. Bokhan NA, Ivanova SA, Levchuk LA. Serotonin system in modulation of depressive and addictive behavior. Tomsk: National Research Tomsk State University Publishing House, 2013:102 (in Russian).
  15. Maximova NM, Bulgakova TS, Uzbekov MG. The role of cytokines in pathogenesis and therapy of mental disorders. Social and Clinical Psychiatry. 2019; 29(3):71-77 (in Russian).
  16. Kevin SD. Risk assessment for criminal and violent behavior amongst adults. In book: Reference Module in Neuroscience and Biobehavioral Psychology. Elsevier, 2022. doi:10.1016/B978-0-323-91497-0.00208-3
  17. Folino E, Arbach K. Violence risk assessment in forensic patients using HCR-20v3: interrater reliability and concurrent validity]. Vertex. 2021 Mar;XXXII(151):32-44. Spanish. doi: 10.53680/vertex.v32i151.23. PMID: 34783775.
  18. Toshchakova VA, Vyalova NM, Boyko AS, Gusev SI, Ivanova SA, Bokhan NA. The level of cortisol and adrenocorticotropic hormone in individuals with criminal behavior. Basic Research. 2013;12-1:81-84 (in Russian).
  19. Gavrilova VA, Ivanova SA, Gusev SI, Trofimova MV, Bokhan NA. Neurosteroids dehydroepiandrosterone and its sulfate in individuals with personality disorders convicted of serious violent crimes. Bull Exp Biol Med. 2012 Nov;154(1):89-91. doi: 10.1007/s10517-012-1882-6. PMID: 23330098.
  20. Davidson M, Rashidi N, Nurgali K, Apostolopoulos V. The role of tryptophan metabolites in neuropsychiatric disorders. Int J Mol Sci. 2022 Sep 1;23(17):9968. doi: 10.3390/ijms23179968. PMID: 36077360; PMCID: PMC9456464.
  21. Ruthirakuhan M, Lanctôt KL, Di Scipio M, Ahmed M, Herrmann N. Biomarkers of agitation and aggression in Alzheimer's disease: A systematic review. Alzheimers Dement. 2018 Oct;14(10):1344-1376. doi: 10.1016/j.jalz.2018.04.013. Epub 2018 Jun 23. PMID: 29940162.
  22. StoyakVA, IvanovaSA. Neurotransmitter systems in the regulation of aggressive behavior (literature review). Siberian Herald of Psychiatry and Addiction Psychiatry. 2010;3(60):70-76(in Russian).
  23. Carré JM, Robinson BA. Testosterone administration in human social neuroendocrinology: Past, present, and future. Horm Behav. 2020 Jun;122:104754. doi: 10.1016/j.yhbeh.2020. 104754. Epub 2020 May 8. PMID: 32333931.
  24. Makushkina OA, Gurina OI, Golenkova VA. Clinical, social and biological aspects of the prediction of aggressive illegal behavior of persons with severe mental disorders. Mental Health. 2023; 22(3):3-15. doi:10.25557/2074-014X.2023.03.3-15 (in Russian).
  25. Ivanova SA, Toshchakova VA, Bokhan NA. Hormonal factors in the regulation of aggression. Tomsk: Printing House “Ivan Fedorov”, 2014:108 (in Russian).
  26. Veselova IA, Sergeeva EA, Makedonskaya MI, Eremina OE, Kalmykov SN, Shekhovtsova TN. Methods for determining neurotransmitter metabolism markers for clinical diagnostics. Journal of Analytical Chemistry. 2016; 71(12): 1235-1249. doi:10.7868/S0044450216120124(in Russian).
  27. Lyubimova NV, Timofeev YuS. Biochemical markers of neuroendocrine tumors: general concepts, clinical significance. Handbook of the Head of the Clinical Diagnostic Laboratory. 2017;6:46-61 (in Russian).
  28. Nichkova MI, Huisman H, Wynveen PM, Marc DT, Olson KL, Kellermann GH. Evaluation of a novel ELISA for serotonin: urinary serotonin as a potential biomarker for depression. Anal Bioanal Chem. 2012 Feb;402(4):1593-600. doi: 10.1007/s00216-011-5583-1. Epub 2011 Dec 10. PMID: 22160204.
  29. Chekhonin VP, Baklaushev VP, Kogan BM, Savchenko EA, Lebedev SV, Man'kovskaya IV, Filatova TS, Yusupova IU, Dmitrieva TB. Catecholamines and their metabolites in the brain and urine of rats with experimental Parkinson's disease. Bull Exp Biol Med. 2000 Aug;130(8):805-9. doi: 10.1007/BF02766101. PMID: 11177250.
  30. Dmitrieva TB, Drozdov AZ, Kogan BM. Clinical neurochemistry in psychiatry. Moscow, 1998:298(in Russian).
  31. Nichkova M, Wynveen PM, Marc DT, Huisman H, Kellermann GH. Validation of an ELISA for urinary dopamine: applications in monitoring treatment of dopamine-related disorders. J Neurochem. 2013 Jun;125(5):724-35. doi: 10.1111/jnc.12248. Epub 2013 Apr 25. PMID: 23530945.
  32. Calanchini M, Tadman M, Krogh J, Fabbri A, Grossman A, Shine B. Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection. Endocr Connect. 2019 Aug 1;8(8):1082-1088. doi: 10.1530/EC-19-0269. PMID: 31265996; PMCID: PMC6652243.
  33. Cangemi G, Barco S, Reggiardo G, Viscardi E, Di Cataldo A, Garaventa A, Melioli G, Conte M. Interchangeability between 24-hour collection and single spot urines for vanillylmandelic and homovanillic acid levels in the diagnosis of neuroblastoma. Pediatr Blood Cancer. 2013 Dec;60(12):E170-2. doi: 10.1002/pbc.24671. Epub 2013 Jun 29. PMID: 23813598.
  34. Hinz M, Stein A, Uncini T. Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine. Open Access J Urol. 2011 Feb 4;3:19-24. doi: 10.2147/OAJU.S16637. Retraction in: Res Rep Urol. 2020 Dec 16;12:659. PMID: 24198631; PMCID: PMC3818932.
  35. Newman M, Curran DA. Reliability of a dried urine test for comprehensive assessment of urine hormones and metabolites. BMC Chem. 2021 Mar 15;15(1):18. doi: 10.1186/s13065-021-00744-3. PMID: 33722278; PMCID: PMC7962249.
  36. McAdam R. Physiological correlates of happiness: Role of serotonin and BDNF. 1 May, 2007. Accessed April 13, 2023. https://open.library. ubc.ca/soa/cIRcle/collections/undergraduateresearch/52966/items/1.0086038
  37. Qian QQ, Tan QQ, Sun D, Lu Q, Xin YY, Wu Q, Zhou Y, Liu YX, Tian PC, Liu ZS. A pilot study on plasma and urine neurotransmitter levels in children with tic disorders. Brain Sci. 2022 Jul 4;12(7):880. doi: 10.3390/brainsci12070880. PMID: 35884687; PMCID: PMC9313232.
  38. Wijaya CS, Lee JJZ, Husain SF, Ho CSH, McIntyre RS, Tam WW, Ho RCM. Differentiating medicated patients suffering from major depressive disorder from healthy controls by spot urine measurement of monoamines and steroid hormones. Int J Environ Res Public Health. 2018 Apr 26;15(5):865. doi: 10.3390/ijerph15050865. PMID: 29701669; PMCID: PMC5981904.
  39. Makushkina OA. Methodology for structured risk assessment of dangerous behavior of persons with mental disorders (SOROP). Guidelines. Moscow: Federal State Budgetary Institution “V.P. Serbsky National Medical Research Center for Psychiatry and Narcology” of the Ministry of Health of Russia, 2020:37 (in Russian).