Question:
In adults with schizophrenia, what is the association between affective symptoms and subsequent violence towards others and themselves?
Answer:
No definite clinical recommendations can be made from the
available evidence. Three primary studies were found, all had
observational study designs and only one study was at low risk of
bias. The best quality study was a case-control study which
concluded that psychotic and depressive symptom scores were
predictors of suicide risk. The other studies concluded that psychotic,
affective and hostility symptoms were higher in people experiencing
panic attacks; and that threat control over-ride symptoms
and depression were associated with aggressive behaviour. It
appears that more good quality studies, ideally with an adequate
sample size and prospective design, are needed to evaluate the
relationship between affective symptoms and violent behaviour
in schizophrenia.
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