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Psychopharmacology (Berl). 2016 Feb;233(4):571-8. doi: 10.1007/s00213-015-4167-8. Epub 2015 Dec 3.

Medication and aggressiveness in real-world schizophrenia. Results from the FACE-SZ dataset.

Author information

1
Fondation FondaMental, Créteil, France. guillaume.fond@gmail.com.
2
INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 40 rue de Mesly, F-94010, Créteil, France. guillaume.fond@gmail.com.
3
Bordeaux Sleep Clinique, Pellegrin University Hospital, USR CNRS 3413 SANPSY, Research Unit, Bordeaux University, 33000, Bordeaux, France. guillaume.fond@gmail.com.
4
Fondation FondaMental, Créteil, France.
5
Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, F-13274, Marseille cedex 09, France.
6
Bordeaux Sleep Clinique, Pellegrin University Hospital, USR CNRS 3413 SANPSY, Research Unit, Bordeaux University, 33000, Bordeaux, France.
7
INSERM U955, équipe de psychiatrie translationnelle, Créteil, France, Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, 40 rue de Mesly, F-94010, Créteil, France.
8
Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076, Bordeaux, France.
9
Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000, Bordeaux, France.
10
INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
11
Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France.
12
CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France.
13
Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier, Pole Est BP 300 39-95 bd, Pinel - 69678, BRON Cedex, France.
14
AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Faculté de médecine, Sorbonne, Paris Cité, France.
15
Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France.
16
Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France.
17
CNRS UMR 5287-INCIA, Bordeaux, France.
18
Service de psychiatrie d'adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France.

Abstract

INTRODUCTION:

The primary objective of this study was to determine if second-generation antipsychotic (SGA) administration was associated with lower aggressiveness scores compared to first-generation (FGA) in schizophrenia (SZ). The secondary objective was to determine if antidepressants, mood stabilizers, and benzodiazepines administration were respectively associated with lower aggressiveness scores compared to patients who were not administered these medications.

METHODS:

Three hundred thirty-one patients with schizophrenia (N = 255) or schizoaffective disorder (N = 76) (mean age = 32.5 years, 75.5 % male gender) were systematically included in the network of FondaMental Expert Center for Schizophrenia and assessed with the structured clinical interview for DSM-IV Axis I disorders and validated scales for psychotic symptomatology, insight, and compliance. Aggressiveness was measured by the Buss-Perry Aggression Questionnaire (BPAQ) score. Ongoing psychotropic treatment was recorded.

RESULTS:

Patients who received SGA had lower BPAQ scores than patients who did not (p = 0.01). More specifically, these patients had lower physical and verbal aggression scores. On the contrary, patients who received benzodiazepines had higher BPAQ scores than patients who did not (p = 0.04). No significant difference was found between BPAQ scores of patients respectively being administered mood stabilizers (including valproate), antidepressant, and the patients who were not. These results were found independently of socio-demographical variables, psychotic symptomatology, insight, compliance into treatment, daily-administered antipsychotic dose, the way of antipsychotic administration (oral vs long acting), current alcohol disorder, and daily cannabis consumption.

CONCLUSION:

The results of the present study are in favor of the choice of SGA in SZ patients with aggressiveness, but these results need further investigation in longitudinal studies. Given the potent side effects of benzodiazepines (especially dependency and cognitive impairment) and the results of the present study, their long-term prescription is not recommended in patients with schizophrenia and aggressive behavior.

KEYWORDS:

Aggressiveness; Antipsychotic; Benzodiazepine; Buss perry scale; Schizophrenia; Violence

PMID:
26630993
DOI:
10.1007/s00213-015-4167-8
[Indexed for MEDLINE]

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