Format

Send to

Choose Destination
Aggress Behav. 2007 Jan-Feb;33(1):86-96.

Insight into illness and adherence to psychotropic medications are separately associated with violence severity in a forensic sample.

Author information

1
Brookhaven National Laboratory, Upton, New York 11973-5000, USA. 11973-5000. E-mail: nellyklein@bnl.gov

Abstract

Violence towards others by a minority of psychotic individuals is a significant public health concern. The severity of this other-directed violence (ODV) in the community may be influenced by insight into illness and adherence to psychotropic medications; however, few studies have tested these associations. Sixty male psychotic inpatients, legally detained at a forensic unit in New York City, were assessed with semi-structured interviews, supplemented with information from hospital and official records, family members and the treating clinician. Results indicated that in this unique sample of detained persons with psychotic disorders; (1) increase in the severity of community violence is associated with medication non-adherence, all dimensions of poor insight into illness, and several previously reported covariates such as substance use comorbidity; (2) no relationship was found between insight and adherence in this particular sample; (3) multivariate analyses showed that select covariates, along with medication adherence, and select insight domains predicted a total of 73% of the magnitude of ODV behavior in this sample. Overall, medication non-adherence explained a large amount of how violently participants behaved toward others. Since non-adherence was independent of poor insight, it may be more worthwhile for clinicians to develop treatment strategies to target medication adherence without directly addressing an elusive target such as insight into illness. Treatment addressing medication adherence needs to concomitantly target substance use behaviors since the latter was responsible for a substantial increase in ODV.

PMID:
17441009
DOI:
10.1002/ab.20170
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center