Question: In adults with schizophrenia, what is the association between affective symptoms and subsequent violence towards others and themselves?


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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