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Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study.

https://arctichealth.org/en/permalink/ahliterature259887
Source
Schizophr Res. 2014 Jul;156(2-3):272-6
Publication Type
Article
Date
Jul-2014
Author
Johannes Langeveld
Stål Bjørkly
Bjørn Auestad
Helene Barder
Julie Evensen
Wenche Ten Velden Hegelstad
Inge Joa
Jan Olav Johannessen
Tor Ketil Larsen
Ingrid Melle
Stein Opjordsmoen
Jan Ivar Røssberg
Bjørn Rishovd Rund
Erik Simonsen
Per Vaglum
Thomas McGlashan
Svein Friis
Source
Schizophr Res. 2014 Jul;156(2-3):272-6
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Adult
Antipsychotic Agents - therapeutic use
Crime
Denmark - epidemiology
Follow-Up Studies
Humans
Logistic Models
Middle Aged
Multivariate Analysis
Norway - epidemiology
Prevalence
Prospective Studies
Psychiatric Status Rating Scales
Psychotherapy
Psychotic Disorders - diagnosis - epidemiology - therapy
Risk
Substance-Related Disorders - epidemiology
Violence
Young Adult
Abstract
First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis.
To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior.
A prospective design was used with comprehensive assessments of criminal behavior, drug abuse, clinical, social and treatment variables at baseline, five, and 10-year follow-up. Additionally, threatening and violent behavior was assessed at 10-year follow-up. A clinical epidemiological sample of first-episode psychosis patients (n=178) was studied.
During the 10-year follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found to be predictive of violent behavior during the year preceding the 10-year follow-up.
After treatment initiation, the overall prevalence of violence in psychotic patients drops gradually to rates close to those of the general population. However, persistent illicit drug abuse is a serious risk factor for violent behavior, even long after the start of treatment. Achieving remission early and reducing substance abuse may contribute to a lower long-term risk for violent behavior in FEP patients.
PubMed ID
24837683 View in PubMed
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