Abstract
BackgroundThe relationship between violence and neurocognitive function in schizophrenia is unclear. We examined the backgrounds and neurocognitive functions of violent and nonviolent patients with schizophrenia to identify factors associated with serious violence.MethodsThirty male patients with schizophrenia who were hospitalized after committing serious violent acts were compared with 24 hospitalized male patients with schizophrenia and no history of violence. We evaluated psychiatric symptoms using the Positive and Negative Syndrome Scale (PANSS) and neurocognitive functions using the Brief Assessment of Cognition in Schizophrenia (BACS)-Japanese version.ResultsRepeated-measures analyses of variance on BACS subcomponents z-scores showed that the violent and control groups had different neuropsychological profiles at trend level (p = 0.095). Post hoc analyses of variance indicated that the violent group had significantly better working memory and executive function than the control group. In post hoc ANOVAs also controlling for the effect of the presence of substance abuse on cognitive function, violent or nonviolent group had a significant main effect on executive function but not on working memory.ConclusionsPatient with violent or non-violent schizophrenia have distinct neuropsychological profiles. These results may help develop improved psychosocial treatments.
Highlights
The relationship between violence and neurocognitive function in schizophrenia is unclear
Some studies indicate that patients with schizophrenia who have a violent behavioral history perform better on tests of executive function than nonviolent patients [3, 8]
Several studies reported no differences in neurocognitive functions between patients with schizophrenia and violent behavior, and those with schizophrenia but no Kashiwagi et al Ann Gen Psychiatry (2015) 14:46 violent behavior [10,11,12,13,14]
Summary
The relationship between violence and neurocognitive function in schizophrenia is unclear. Some studies indicate that patients with schizophrenia who have a violent behavioral history perform better on tests of executive function than nonviolent patients [3, 8]. In two reports, executive dysfunction was found to be a predictor of aggression in patients with schizophrenia, as measured by tools such as the Modified Overt Aggression Scale [5, 16]. These inconsistent findings seem to be the result of differences in study methodologies, differences in the definitions of violent behavior, differences in the severity of the violence, differences in the study settings such as inpatient and outpatient, and differences in the heterogeneity of patient characteristics. Differences between violence that occurs in the community and that during hospitalization may explain such inconsistencies
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