Violence among schizophrenia out-patients compliant with medication: prevalence and associated factors.
OBJECTIVE
Aggressive behaviour has been related to schizophrenia both in in-patient and out-patient samples. In this study, we aimed to assess the prevalence and factors associated with aggressive behaviour in out-patient compliant with their prescribed medication.


METHODS
Eight hundred and ninety-five patients were interviewed at Community-Based Mental Health Services about aggressive-violent behaviour within the week prior to the study visit. Adult patients diagnosed with schizophrenia and receiving stable pharmacological treatment were enrolled. Presence of aggressive episodes, including type of aggression, severity and frequency, was assessed with the Modified Overt Aggression Scale (MOAS). Violence was defined as a score of 3 or more in any of the MOAS subscores.


RESULTS
Prevalence of recent aggressive behaviour was 5.07%, (95% CI 5.04-5.10), where 47% (43 behaviours 91) reached the violent threshold. Among the 91 violent episodes rated, most episodes were verbal (44%), followed by physical violence towards objects (29%), violence towards others (19%) and self-directed violence (8%). Recent episodes of any severity were more likely among patients with a history of violence and also with relapses within the previous year and with low treatment satisfaction.


CONCLUSIONS
Five per cent of the studied cases showed aggressive behaviour in the week prior to assessment, despite having been compliant with their medication. Most aggressive behaviour was verbal rather than physical.
Bobes
J
J
School of Medicine, Psychiatry Department, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain. bobes@uniovi.es
Fillat
O
O
Arango
C
C
D000328:Adult; D000374:Aggression / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D006306:Health Surveys; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*; D012563:Schizophrenia, Paranoid / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D012565:Schizophrenic Psychology; D013030:Spain; D019966:Substance-Related Disorders / Q000453:epidemiology; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*
D014150:Antipsychotic Agents; D013287:Illicit Drugs