1
|
Buizza C, Strozza C, Sbravati G, de Girolamo G, Ferrari C, Iozzino L, Macis A, Kennedy HG, Candini V. Positive and negative syndrome scale in forensic patients with schizophrenia spectrum disorders: a systematic review and meta-analysis. Ann Gen Psychiatry 2022; 21:36. [PMID: 36088451 PMCID: PMC9463849 DOI: 10.1186/s12991-022-00413-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/19/2022] [Indexed: 01/10/2023] Open
Abstract
Among forensic patients with schizophrenia spectrum disorders, the association between symptomatology and violence is still not entirely clear in literature, especially because symptoms shift both during the acute phase of the illness and after. The aims were to investigate the level of symptomatology in forensic patients and to evaluate if there are differences in the level of symptoms between forensic and non-forensic patients. According to PRISMA guidelines, a systematic search was performed in PubMed, Web of Science, and ProQuest, using the following key words: "forensic" AND "Positive and Negative Syndrome Scale" OR "PANSS". A total of 27 studies were included in the systematic review, while only 23 studies in the meta-analysis. The overall sample included a total of 1702 participants, most commonly male and inpatients in forensic settings. We found that studies with an entirely male sample had significantly lower Positive PANSS ratings than studies with mixed samples. Although both forensic and non-forensic patients were affected by mild psychopathological symptoms, forensic patients presented higher ratings in all four PANSS scales. This meta-analysis shows that forensic patients reported a mild level of symptomatology, as assessed with the PANSS, and therefore might be considered as patients in partial remission. Among patients with schizophrenia, the association between symptoms and violence is very complex: many factors might be considered as key mediators and thus should be taken into account to explain this association. Further studies are needed.Trial registration all materials and data can be found on the OSF framework: https://osf.io/5ceja (date of registration: 8 September 2021).
Collapse
Affiliation(s)
- Chiara Buizza
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Cosmo Strozza
- Interdisciplinary Centre On Population Dynamics, University of Southern Denmark, 5000, Odense, Denmark
| | - Giulio Sbravati
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Giovanni de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Laura Iozzino
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy
| | - Harry G Kennedy
- The National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14, Ireland.,Academic Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Valentina Candini
- Psychiatric Epidemiology and Evaluation Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.
| |
Collapse
|
2
|
Balcioglu YH, Kirlioglu Balcioglu SS, Oncu F, Turkcan A. Psychopathy, temperament, and character dimensions of personality as risk determinants of criminal recidivism in schizophrenia patients. J Forensic Sci 2021; 66:2340-2353. [PMID: 34403139 DOI: 10.1111/1556-4029.14834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/14/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
There is considerable evidence on the role of personality traits in the risk of criminal recidivism among schizophrenia patients, besides conventional risk factors. We evaluated the effects of psychopathy and biopsychosocial personality model on general criminal recidivism in schizophrenia patients. Ninety-four male DSM-5 diagnosed schizophrenia patients were recruited and classified into three groups according to the number of offenses since diagnosis: reoffenders (n = 32), Initial offenders (n = 31), and nonoffenders (n = 31). All subjects were evaluated by the Turkish versions of Psychopathy Checklist-Revised (PCL-R) and Temperament and Character Inventory-Revised (TCI-R). In Reoffenders, all subscale scores of PCL-R and Novelty seeking were the highest, while Self-directedness and Cooperativeness were the lowest. PCL-R Total, Factor 1 and Factor 2 positively correlated with Novelty Seeking, and negatively correlated with Harm Avoidance, Self-directedness, and Cooperativeness in offender patients. For criminal recidivism in offender patients, high PCL-R Total and Novelty Seeking, low Harm Avoidance, Self-directedness, and Cooperativeness, being unmarried, presence of childhood adversity, and younger age at the first offense were found to be significant predictors in univariate analyses; multivariate regression models revealed PCL-R Total and Persistence as the only significant predictors. These results suggest that certain dimensional personality evaluations combined with potential historical, clinical, and forensic risk factors can be employed in forensic settings to screen offender schizophrenia patients at an increased risk of recidivism and to take necessary precautions against further criminal behavior.
Collapse
Affiliation(s)
- Yasin Hasan Balcioglu
- Forensic Psychiatry Unit, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | | | - Fatih Oncu
- Forensic Psychiatry Unit, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Ahmet Turkcan
- Forensic Psychiatry Unit, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| |
Collapse
|
3
|
Candidate symptomatic markers for predicting violence in schizophrenia: A cross-sectional study of 7711 patients in a Chinese population. Asian J Psychiatr 2021; 59:102645. [PMID: 33845298 DOI: 10.1016/j.ajp.2021.102645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Violent behaviour is an alarming problem among schizophrenia patients. The effects of historical, clinical, and pathological risk factors for violence have been investigated by multiple studies, but consensus has not been achieved. As psychotic symptoms are more direct and intuitive indicators for violence, identifying robustly associated symptoms is a crucial part of the future prediction and precise management of violent patients in clinics. This study aims to identify the psychotic symptoms correlated with violence among schizophrenia patients in a Chinese population. METHODS In this cross-sectional study, the medical records of 7711 schizophrenia patients (4711 in the discovery set and 3000 in the validation set) were collected from 1998 to 2010. Their psychotic symptoms were extracted, and the patients were divided into violent and non-violent groups. Multivariate logistic analysis was applied to identify symptoms associated with violence in the discovery set. RESULTS Eight psychotic symptoms were found to be significantly correlated with violence in schizophrenia. "Destruction of property", "verbal aggression" and "insomnia" increased the risk of violence, while "flat affect", "delusion of persecution", "auditory hallucination", "vagueness of thought" and "poverty of thought" decreased the risk of violence. The regression model was evaluated by receiver operating characteristic (ROC) analysis for its discriminatory performance, achieving area under curve (AUC) values of 0.887 in the discovery sample set and 0.824 in the validation sample set. CONCLUSIONS The correlated symptoms identified by this study can serve as future candidate predictors for violence in schizophrenia, paving the way for precise management of schizophrenia patients in clinics.
Collapse
|
4
|
Mamah D, Cloninger CR, Mutiso VN, Gitonga I, Tele A, Ndetei DM. Personality Traits as Markers of Psychosis Risk in Kenya: Assessment of Temperament and Character. ACTA ACUST UNITED AC 2020; 1:sgaa051. [PMID: 33215089 PMCID: PMC7656989 DOI: 10.1093/schizbullopen/sgaa051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Specific personality traits have been proposed as a schizophrenia-related endophenotype and confirmed in siblings at risk for psychosis. The relationship of temperament and character with psychosis has not been previously investigated in Africa. The study was conducted in Kenya, and involved participants at clinical high-risk (CHR) for psychosis (n = 268) and controls (n = 251), aged 15–25 years. CHR status was estimated using the Structured Interview of Psychosis-Risk Syndromes (SIPS) and the Washington Early Psychosis Center Affectivity and Psychosis (WERCAP) Screen. Student’s t-tests were used to assess group differences on the Temperament and Character Inventory (TCI). Neurocognitive functioning, stress severity, and substance use were correlated with the TCI, correcting for psychosis severity. CHR participants were more impulsive (ie, higher novelty seeking [NS]) and asocial (ie, lower reward dependence) than controls. They were also more schizotypal (ie, high self-transcendence [ST] and lower self-directedness [SD] and cooperativeness [CO] than controls). CO was related to logical reasoning, abstraction, and verbal memory. Stress severity correlated with high HA and schizotypal character traits. Lifetime tobacco use was related to NS, and lifetime marijuana use to high NS, low SD and high ST. Temperament and character of Kenyan CHR youth is similar to that observed in schizophrenia. Psychosis risk in Kenya is associated with impulsive, asocial, and schizotypal traits. CHR adolescents and young adults with schizophrenia-specific personality traits may be most at risk for developing a psychotic disorder and to require early intervention to improve outcomes.
Collapse
Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO
| | - C Robert Cloninger
- Department of Psychiatry, Washington University Medical School, St. Louis, MO
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Isaiah Gitonga
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Albert Tele
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| |
Collapse
|