title: Trajectory classes of violent behavior and their relationship to lipid levels in schizophrenia inpatients.
abstract: OBJECTIVE
  To characterize the trajectory patterns of violence in schizophrenia inpatients, examine the relationships between the violence trajectories and baseline clinical features and lipid levels, and generate a model to predict the more violent trajectories.
  
  
  METHODS
  In a sample of 107 consecutively admitted patients with schizophrenia spectrum disorders, violent behavior was weekly rated using the Violence Scale. The patients' blood levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured at admission. A trajectory analysis was used to classify the patients' longitudinal courses in violence, and the correlates of these trajectories were assessed using multinomial logistic regression analyses. A stepwise logistic regression was used to select the best predictor variables for the more violent trajectories.
  
  
  RESULTS
  Four violence trajectories of inpatients were obtained: class 1 (no violence, 37.4%), class 2 (low-leveling off, 39.2%), class 3 (high-falling sharply, 10.3%), and class 4 (high-falling slowly, 13.1%). Although the relationship between decreasing TC and TG levels and increased violence in the trajectory classes did not reach statistical significance, a decreasing trend in the proportion of high dichotomized-TG levels was significantly associated with more violence in the trajectory classes (p = 0.04). A five-variable model consisting of female gender, early onset, higher scores of positive symptoms, lower scores of negative symptoms, and low dichotomized-TC levels had a predictive accuracy of 0.85 (95% CI = 0.72-0.97).
  
  
  CONCLUSIONS
  Distinct violence trajectories exist in schizophrenia inpatients, and the more violent trajectories can be predicted using baseline clinical features and lipid levels.
authors.affiliation: School of Nursing, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei 100, Taiwan.
authors.forename: Shing-Chia
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
authors.forename: Ni-Hsuan
authors.initials: NH
authors.lastname: Chu
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan.
authors.forename: Hai-Gwo
authors.initials: HG
authors.lastname: Hwu
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan. Electronic address: wjchen@ntu.edu.tw.
authors.forename: Wei J
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D017668:Age of Onset; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000097:blood*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood*; D014754:Violence
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Lipid levels; Predictive accuracy; Schizophrenia inpatients; Trajectories; Violence