40
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Risk Factors for Violence in Psychosis: Systematic Review and Meta-Regression Analysis of 110 Studies

      1 , 2 ,   1 , *

      PLoS ONE

      Public Library of Science

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Previous reviews on risk and protective factors for violence in psychosis have produced contrasting findings. There is therefore a need to clarify the direction and strength of association of risk and protective factors for violent outcomes in individuals with psychosis.

          Method

          We conducted a systematic review and meta-analysis using 6 electronic databases (CINAHL, EBSCO, EMBASE, Global Health, PsycINFO, PUBMED) and Google Scholar. Studies were identified that reported factors associated with violence in adults diagnosed, using DSM or ICD criteria, with schizophrenia and other psychoses. We considered non-English language studies and dissertations. Risk and protective factors were meta-analysed if reported in three or more primary studies. Meta-regression examined sources of heterogeneity. A novel meta-epidemiological approach was used to group similar risk factors into one of 10 domains. Sub-group analyses were then used to investigate whether risk domains differed for studies reporting severe violence (rather than aggression or hostility) and studies based in inpatient (rather than outpatient) settings.

          Findings

          There were 110 eligible studies reporting on 45,533 individuals, 8,439 (18.5%) of whom were violent. A total of 39,995 (87.8%) were diagnosed with schizophrenia, 209 (0.4%) were diagnosed with bipolar disorder, and 5,329 (11.8%) were diagnosed with other psychoses. Dynamic (or modifiable) risk factors included hostile behaviour, recent drug misuse, non-adherence with psychological therapies ( p values<0.001), higher poor impulse control scores, recent substance misuse, recent alcohol misuse ( p values<0.01), and non-adherence with medication ( p value <0.05). We also examined a number of static factors, the strongest of which were criminal history factors. When restricting outcomes to severe violence, these associations did not change materially. In studies investigating inpatient violence, associations differed in strength but not direction.

          Conclusion

          Certain dynamic risk factors are strongly associated with increased violence risk in individuals with psychosis and their role in risk assessment and management warrants further examination.

          Related collections

          Most cited references 37

          • Record: found
          • Abstract: found
          • Article: not found

          The positive and negative syndrome scale (PANSS) for schizophrenia.

          The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Meta-analysis: recent developments in quantitative methods for literature reviews.

            We describe the history and current status of the meta-analytic enterprise. The advantages and historical criticisms of meta-analysis are described, as are the basic steps in a meta-analysis and the role of effect sizes as chief coins of the meta-analytic realm. Advantages of the meta-analytic procedures include seeing the "landscape" of a research domain, keeping statistical significance in perspective, minimizing wasted data, becoming intimate with the data summarized, asking focused research questions, and finding moderator variables. Much of the criticism of meta-analysis has been based on simple misunderstanding of how meta-analyses are actually carried out. Criticisms of meta-analysis that are applicable are equally applicable to traditional, nonquantitative, narrative reviews of the literature. Much of the remainder of the chapter deals with the processes of effect size estimation, the understanding of the heterogeneity of the obtained effect sizes, and the practical and scientific importance of the effect sizes obtained.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The prediction of criminal and violent recidivism among mentally disordered offenders: a meta-analysis.

              A meta-analysis was conducted to examine whether the predictors of recidivism for mentally disordered offenders are different from the predictors for nondisordered offenders. Effect sizes were calculated for 35 predictors of general recidivism and 27 predictors of violent recidivism drawn from 64 unique samples. The results showed that the major predictors of recidivism were the same for mentally disordered offenders as for nondisordered offenders. Criminal history variables were the best predictors, and clinical variables showed the smallest effect sizes. The findings suggest that the risk assessment of mentally disordered offenders can be enhanced with more attention to the social psychological criminological literature and less reliance on models of psychopathology.
                Bookmark

                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                13 February 2013
                : 8
                : 2
                Affiliations
                [1 ]Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, Oxfordshire, United Kingdom
                [2 ]Research Triangle Institute International, Research Triangle Park, Durham, North Carolina, United States of America
                Baylor College of Medicine, United States of America
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: SF KW. Performed the experiments: SF KW. Analyzed the data: KW. Contributed reagents/materials/analysis tools: RVD. Wrote the paper: SF KW RVD.

                Article
                PONE-D-12-25677
                10.1371/journal.pone.0055942
                3572179
                23418482

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Pages: 15
                Funding
                No current external funding sources for this study. SF is supported by the Wellcome Trust. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine
                Clinical Research Design
                Meta-Analyses
                Systematic Reviews
                Mental Health
                Psychiatry
                Psychoses
                Schizophrenia
                Psychology
                Clinical Psychology
                Therapies
                Social and Behavioral Sciences
                Psychology
                Clinical Psychology
                Therapies
                Sociology
                Crime and Criminology

                Uncategorized

                Comments

                Comment on this article