title: Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia.
abstract: BACKGROUND
  Violence is an uncommon but significant problem associated with schizophrenia.
  
  
  OBJECTIVE
  To compare antipsychotic medications in reducing violence among patients with schizophrenia over 6 months, identify prospective predictors of violence and examine the impact of medication adherence on reduced violence.
  
  
  METHODS
  Participants (n=1445) were randomly assigned to double-blinded treatment with one of five antipsychotic medications. Analyses are presented for the intention-to-treat sample and for patients completing 6 months on assigned medication.
  
  
  RESULTS
  Violence declined from 16% to 9% in the retained sample and from 19% to 14% in the intention-to-treat sample. No difference by medication group was found, except that perphenazine showed greater violence reduction than quetiapine in the retained sample. Medication adherence reduced violence, but not in patients with a history of childhood antisocial conduct. Prospective predictors of violence included childhood conduct problems, substance use, victimisation, economic deprivation and living situation. Negative psychotic symptoms predicted lower violence.
  
  
  CONCLUSIONS
  Newer antipsychotics did not reduce violence more than perphenazine. Effective antipsychotics are needed, but may not reduce violence unrelated to acute psychopathology.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 905 West Main Street, Durham, NC 27710, USA. jeffrey.swanson@duke.edu
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Swanson
authors.forename: Marvin S
authors.initials: MS
authors.lastname: Swartz
authors.forename: Richard A
authors.initials: RA
authors.lastname: Van Dorn
authors.forename: Jan
authors.initials: J
authors.lastname: Volavka
authors.forename: John
authors.initials: J
authors.lastname: Monahan
authors.forename: T Scott
authors.initials: TS
authors.lastname: Stroup
authors.forename: Joseph P
authors.initials: JP
authors.lastname: McEvoy
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
authors.forename: Eric B
authors.initials: EB
authors.lastname: Elbogen
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D014754:Violence
chemical_list: D014150:Antipsychotic Agents