Evidence for an agitated-aggressive syndrome in early-onset psychosis correlated with antisocial personality disorder, forensic history, and substance use disorder.
Agitation, aggression, and violence are increased in psychotic disorders. Additionally, an earlier age at onset may be associated with aggressive behavior. However, the relationship of age at onset, an agitated-aggressive syndrome as measured with the Positive And Negative Syndrome Scale for Schizophrenia - Excited Component (PANSS-EC), and its potential correlates in first-episode psychosis (FEP) has not been studied.



This study assessed the association between age at onset, an agitated-aggressive syndrome, and its potential correlates in a prospective sample of 52 FEP patients with early-onset and adult-onset followed up for 12months.



Twenty-six patients conformed to the criteria of early-onset psychosis. Early age at onset was associated with antisocial personality disorder (p=0.004; φc=0.39), a history of legal involvement (p=0.005; φc=0.39), and higher rates of lifetime substance use disorder (SUD; p=0.002; φc=0.42). Early-onset patients had significantly higher PANSS-EC scores over the course of observation (F(1,44.4)=5.39; p=0.025; d=0.656), but no significant group differences emerged for the remaining PANSS subscores. PANSS-EC scores were correlated positively with antisocial personality disorder and forensic history at 6weeks, 3months, 6months, and 12months, and with lifetime substance use disorder at 3months and 6months.



Patients with early onset psychosis may have increased levels of agitation/aggressiveness, and, more likely, antisocial personality disorder, forensic history, and lifetime substance use disorder. These variables were linked to suicidality, aggressiveness, and involuntary treatment.
Universitäre Psychiatrische Kliniken Basel, Wilhelm Klein-Str. 27, 4012 Basel, Switzerland. Electronic address: christian.huber@upkbs.ch.
Christian G
CG
Huber
Universitäre Psychiatrische Kliniken Basel, Wilhelm Klein-Str. 27, 4012 Basel, Switzerland.
Lisa
L
Hochstrasser
Universitätsklinikum Hamburg-Eppendorf, Klinik für Psychiatrie und Psychotherapie, Martinistr. 52, 20246 Hamburg, Germany.
Klara
K
Meister
University Hospital of Child and Adolescent Psychiatry, University of Bern, Effingerstr. 12, 3011 Bern, Switzerland; Universitätsklinikum Hamburg-Eppendorf, Klinik für Kinder- und Jugendpsychiatrie, Martinistr. 52, 20246 Hamburg, Germany.
Benno G
BG
Schimmelmann
Universitätsklinikum Hamburg-Eppendorf, Klinik für Psychiatrie und Psychotherapie, Martinistr. 52, 20246 Hamburg, Germany.
Martin
M
Lambert
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000374:Aggression; D000987:Antisocial Personality Disorder / Q000150:complications* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation; D011618:Psychotic Disorders / Q000150:complications* / Q000523:psychology*; D012559:Schizophrenia / Q000150:complications; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology; D013577:Syndrome; D055815:Young Adult
Age at onset; Aggression; First-episode psychosis; Hostility; Impulsivity; Schizophrenia