scholarly journals Violent behaviour in schizophrenia

2005 ◽  
Vol 187 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Jan Vevera ◽  
Alan Hubbard ◽  
Arnošt Veselý ◽  
Hana Papežová
Keyword(s):  
Logistic Regression ◽  
Substance Misuse ◽  
Overt Aggression ◽  
Psychotic Symptoms ◽  
Violent Behaviour ◽  
Stable Conditions ◽  
Dsm Iv ◽  
Available Information ◽  
Overt Aggression Scale ◽  
Over Time

BackgroundA number of studies have reported increased violence in patients with schizophrenia.AimsTo determine the prevalence of violence among those with schizophrenia in samples from 1949, 1969, 1989 and 2000 in Prague (Czech Republic) and to examine trends in this behaviour.MethodRecords from 404 patients meeting DSM–IV criteria for schizophrenia were screened for violence (defined as 3 points on the Modified Overt Aggression Scale) from the first observed psychotic symptoms until the time of latest available information.ResultsLogistic regression revealed a marginally significant increase in violence only inthe 2000 cohort. Overall, violence was associated with schizophrenia in 41.8% of men and 32.7% of women, with no association between substance misuse and violence.ConclusionsThe violence rate found in our sample is expected to remain stable over time under stable conditions. Substance misuse is not the leading cause of violence among those with schizophrenia.

scholarly journals Aggressive behaviour in an acute general adult psychiatric unit

2006 ◽  
Vol 30 (5) ◽  
pp. 166-168 ◽  
Author(s):  
Selim M. El-Badri ◽  
Graham Mellsop
Keyword(s):  
Risk Assessment ◽  
Hospital Stay ◽  
Aggressive Behaviour ◽  
Substance Misuse ◽  
Overt Aggression ◽  
Psychiatric Ward ◽  
Clinical Implications ◽  
History Of ◽  
Acute Psychiatric Ward ◽  
Overt Aggression Scale

Aims and MethodThe study aimed to identify the correlates of aggressive behaviour in an adult acute psychiatric ward. Over a period of 9 months, all incidents of verbal and physical aggressive behaviour exhibited by in-patients were routinely assessed using the Overt Aggression Scale.ResultsOf the 535 patients admitted during the study period, 80 (15%) were involved in a total of 124 aggressive incidents. Of these 80, 44 (55%) had a history of previous violence and 54 (68%) had a history of substance misuse. The majority of events occurred early in the hospital stay and in most cases aggression was against staff. There were significant differences between aggressive and non-aggressive patients in terms of gender and ethnicity, with the lowest rate occurring in European females.Clinical ImplicationsThese results reinforce clinical impressions, and empirical evidence, and allow risk assessment to be performed with greater confidence. The relevance of ethnicity (or more likely culture) highlights the difficulties of a ‘one size fits all’ approach to risk assessment.

scholarly journals Aggressive behaviour in patients with schizophrenia is associated with catechol-O-methyltransferase genotype

2001 ◽  
Vol 179 (4) ◽  
pp. 351-355 ◽  
Author(s):  
G. Jones ◽  
S. Zammit ◽  
N. Norton ◽  
M. L. Hamshere ◽  
S. J. Jones ◽  
...  
Keyword(s):  
High Activity ◽  
Odds Ratio ◽  
Aggressive Behaviour ◽  
Lower Risk ◽  
Contingency Table ◽  
Overt Aggression ◽  
Heterozygote Advantage ◽  
Dsm Iv ◽  
Overt Aggression Scale ◽  
Larger Sample

BackgroundEvidence exists for an association between aggression and schizophrenia. Although the aetiology of aggression is multifactorial, three studies have reported associations between polymorphisms of the catechol-O-methyltransferase (COMT) gene and aggression in schizophrenia.AimsTo replicate these findings in a larger sample using the Overt Aggression Scale (OAS).MethodA sample of 180 people with DSM–IV schizophrenia were rated for aggression using the OAS. Kruskal–Wallis and contingency table analyses were applied to the OAS results.ResultsThe high-activity homozygotes showed significantly higher scores of aggression, whereas the heterozygotes showed significantly lower scores. The odds ratio for aggression for the high-activity homozygotes was 2.07 (95% Cl=1.03–4.15), whereas that for the heterozygotes was 0.54 (95% CI=0. 30–1.00).ConclusionsThe high-activity COMT homozygote confers a higher risk of recorded aggression in schizophrenia. Heterozygotes had a significantly lower risk, which may represent an example of heterosis/heterozygote advantage.

scholarly journals 4123 Characterization of Physical Restraint and Sedative Use for Treatment of Agitation in the Emergency Department

2020 ◽  
Vol 4 (s1) ◽  
pp. 125-125
Author(s):  
Ambrose H Wong ◽  
Lauren Crispino ◽  
John Parker ◽  
Caitlin McVaney ◽  
Alana Rosenberg ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Tertiary Care ◽  
Physical Restraint ◽  
Overt Aggression ◽  
Emergency Setting ◽  
Severity Scale ◽  
Restraint Use ◽  
Scale Scores ◽  
Overt Aggression Scale

OBJECTIVES/GOALS: Agitation has high prevalence in the emergency department (ED), but limited evidence exists regarding clinical decisions to use sedatives and physical restraint. We examined clinical factors and agitation attributes impacting thresholds for sedative and restraint use in the emergency setting. METHODS/STUDY POPULATION: We conducted a prospective cohort study of adult patients (318 yo) with acute or escalating agitation during their ED visit at an urban tertiary care referral center. Consecutive patients requiring security presence or scoring >1 on an agitation scale were enrolled during randomized 8-h blocks. We recorded patient characteristics, staff/team factors, and environmental/systems data as well as scores on 3 validated agitation scales: Agitated Behavior Scale, Overt Aggression Scale, and Severity Scale. We performed descriptive analyses, bivariable analyses, and logistic regression modeling of factors with relation to sedative/restraint use. We observed 95 agitation events on unique patients over 2 months. RESULTS/ANTICIPATED RESULTS: Median age was 42, and 62.1% were male. Most frequent chief complaints were alcohol/drug use (37.9%) and psychiatric (23.2%). Majority of events (73.7%) were associated with sedative/restraint use. Factors related to treatment course or staff interactions were the primary reasons for agitation in 56.8% of events. A logistic regression model found no association between demographics and odds of sedative/restraint use. Overt Aggression Scale scores were associated with significantly higher odds of sedative use (AOR 1.62 [1.13–2.32]), while Severity Scale scores had significantly higher odds of restraint use (AOR 1.39 [1.12–1.73]) but significantly lower odds of sedative use (AOR 0.79 [0.64–0.98]). DISCUSSION/SIGNIFICANCE OF IMPACT: External factors may be important targets for behavioral techniques in ED agitation management. Further study of the Severity Scale may allow for earlier detection of agitation and identify causal links between agitation severity and use of sedatives and restraints.

Overt Aggression Scale

1986 ◽  
Author(s):  
Stuart C. Yudofsky ◽  
Jonathan M. Silver ◽  
Wynn Jackson ◽  
Jean Endicott ◽  
Daniel Williams
Keyword(s):  
Overt Aggression ◽  
Overt Aggression Scale

scholarly journals Global Sensory Impairment Independently Predicts Decreased Social Function Over Time

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 414-414
Author(s):  
Anna Huang ◽  
Kristen Wroblewski ◽  
Ashwin Kotwal ◽  
Linda Waite ◽  
Martha McClintock ◽  
...  
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Cognitive Function ◽  
Social Engagement ◽  
Social Function ◽  
Ordinal Logistic Regression ◽  
Sensory Function ◽  
Sensory Impairment ◽  
Over Time

Abstract The classical senses (vision, hearing, touch, taste, and smell) play a key role in social function by allowing interaction and communication. We assessed whether sensory impairment across all 5 modalities (global sensory impairment [GSI]) was associated with social function in older adults. Sensory function was measured in 3,005 home-dwelling older U.S. adults at baseline in the National Social Life, Health, and Aging Project and GSI, a validated measure, was calculated. Social network size and kin composition, number of close friends, and social engagement were assessed at baseline and 5- and 10-year follow-up. Ordinal logistic regression and mixed effects ordinal logistic regression analyzed cross-sectional and longitudinal relationships respectively, controlling for demographics, physical/mental health, disability, and cognitive function (at baseline). Adults with worse GSI had smaller networks (β=-0.159, p=0.021), fewer close friends (β=-0.262, p=0.003) and lower engagement (β=-0.252, p=0.006) at baseline, relationships that persisted at 5 and 10 year follow-up. Men, older people, African-Americans, and those with less education, fewer assets, poor mental health, worse cognitive function, and more disability had worse GSI. Men and those with fewer assets, worse cognitive function, and less education had smaller networks and lower engagement. African-American and Hispanic individuals had smaller networks and fewer close friends, but more engagement. Older respondents also had more engagement. In summary, GSI independently predicts smaller social networks, fewer close friends, and lower social engagement over time, suggesting that sensory decline results in decreased social function. Thus, rehabilitating multisensory impairment may be a strategy to enhance social function as people age.

scholarly journals Comparison of alternative models for personality disorders

2006 ◽  
Vol 37 (7) ◽  
pp. 983-994 ◽  
Author(s):  
LESLIE C. MOREY ◽  
CHRISTOPHER J. HOPWOOD ◽  
JOHN G. GUNDERSON ◽  
ANDREW E. SKODOL ◽  
M. TRACIE SHEA ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Factor Model ◽  
Five Factor Model ◽  
Collaborative Study ◽  
Validation Data ◽  
Categorical Diagnosis ◽  
Dsm Iv ◽  
Dimensional Models ◽  
Marker Variables ◽  
Over Time

Background. The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.Method. Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.Results. All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets failed to improve upon the validity of higher-order factors upon cross-validation. Data demonstrated the importance of both stable trait and dynamic psychopathological influences in predicting external criteria over time.Conclusions. The results support a dimensional representation of PDs that assesses both stable traits and dynamic processes.

scholarly journals Stock assessment and projections incorporating discard estimates in some years: an application to the hake stock in ICES Divisions VIIIc and IXa

2010 ◽  
Vol 67 (6) ◽  
pp. 1185-1197 ◽  
Author(s):  
C. Fernández ◽  
S. Cerviño ◽  
N. Pérez ◽  
E. Jardim
Keyword(s):  
Time Series ◽  
Stock Assessment ◽  
Reference Points ◽  
Assessment Model ◽  
Marine Science ◽  
Fishing Mortality ◽  
Change Over Time ◽  
Age Structured ◽  
Available Information ◽  
Over Time

Abstract Fernández, C., Cerviño, S., Pérez, N., and Jardim, E. 2010. Stock assessment and projections incorporating discard estimates in some years: an application to the hake stock in ICES Divisions VIIIc and IXa. – ICES Journal of Marine Science, 67: 1185–1197. A Bayesian age-structured stock assessment model is developed to take into account available information on discards and to handle gaps in the time-series of discard estimates. The model incorporates mortality attributable to discarding, and appropriate assumptions about how this mortality may change over time are made. The result is a stock assessment that accounts for information on discards while, at the same time, producing a complete time-series of discard estimates. The method is applied to the hake stock in ICES Divisions VIIIc and IXa, for which the available data indicate that some 60% of the individuals caught are discarded. The stock is fished by Spain and Portugal, and for each country, there are discard estimates for recent years only. Moreover, the years for which Portuguese estimates are available are only a subset of those with Spanish estimates. Two runs of the model are performed; one assuming zero discards and another incorporating discards. When discards are incorporated, estimated recruitment and fishing mortality for young (discarded) ages increase, resulting in lower values of the biological reference points Fmax and F0.1 and, generally, more optimistic future stock trajectories under F-reduction scenarios.

scholarly journals Prognosis of adolescent partial syndromes of eating disorder

2008 ◽  
Vol 192 (4) ◽  
pp. 294-299 ◽  
Author(s):  
George C. Patton ◽  
Carolyn Coffey ◽  
John B. Carlin ◽  
Lena Sanci ◽  
Susan Sawyer
Keyword(s):  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Young Adulthood ◽  
Social Adjustment ◽  
Substance Misuse ◽  
Social Role ◽  
Community Sample ◽  
Clinical Intervention ◽  
Health Significance ◽  
Dsm Iv

BackgroundPartial syndromes of eating disorder are common in adolescents but the health significance of these syndromes remains uncertain.AimsTo document the health and social adjustment in young adulthood of females assessed as having a partial syndrome of eating disorder in adolescence.MethodA community sample of 1943 participants was tracked over 10 years in an eight-wave cohort study. A partial syndrome was defined as the fulfilment of at least two DSM-IV criteria for either anorexia or bulimia nervosa at one assessment or more between the ages of 15 years and 17 years.ResultsPartial syndromes were found in 9.4% of 15- to 17-year-old female participants and 1.4% of males. There were few instances of progression of partial syndromes to fully fledged anorexia and bulimia nervosa. However, among those with partial syndromes depressive and anxiety symptoms were two to three times higher in young adulthood, substance misuse was common, and a majority of those with a partial syndrome of anorexia nervosa were still underweight in their mid-20s.ConclusionsGiven the level of subsequent psychopathology and social role impairment, there may be justification for initiating trials of preventive and early clinical intervention strategies for adolescent partial syndromes.

scholarly journals OP0287 A MACHINE LEARNING APPROACH FOR PRECISION STRATIFICATION OF JUVENILE-ONSET SLE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 179.2-179
Author(s):  
G. Robinson ◽  
J. Peng ◽  
P. Dönnes ◽  
L. Coelewij ◽  
M. Naja ◽  
...  
Keyword(s):  
Machine Learning ◽  
Logistic Regression ◽  
T Cell ◽  
B Cell ◽  
T Cell Subsets ◽  
Healthy Controls ◽  
Juvenile Onset ◽  
Immune Signature ◽  
Immune Phenotyping ◽  
Over Time

Background:Juvenile-onset systemic lupus erythematosus (JSLE) is a complex and heterogeneous disease characterised by diagnosis and treatment delays. An unmet need exists to better characterise the immunological profile of JSLE patients and investigate its links with the disease trajectory over time.Objectives:A machine learning (ML) approach was applied to explore new diagnostic signatures for JSLE based on immune-phenotyping data and stratify patients by specific immune characteristics to investigate longitudinal clinical outcome.Methods:Immune-phenotyping of 28 T-cell, B-cell and myeloid-cell subsets in 67 age and sex-matched JSLE patients and 39 healthy controls (HCs) was performed by flow cytometry. A balanced random forest (BRF) ML predictive model was developed (10,000 decision trees). 10-fold cross validation, Sparse Partial Least Squares-Discriminant Analysis (sPLS-DA) and logistic regression was used to validate the model. Longitudinal clinical data were related to the immunological features identified by ML analysis.Results:The BRF-model discriminated JSLE patients from healthy controls with 91% prediction accuracy suggesting that JSLE patients could be distinguished from HCs with high confidence using immunological parameters. The top-ranked immunological features from the BRF-model were confirmed using sPLS-DA and logistic regression and included CD19+ unswitched memory B-cells, naïve B-cells, CD14+monocytes and total CD4+, CD8+and memory T-cell subsets.K-mean clustering was applied to stratify patients using the validated signature. Four groups were identified, each with a distinct immune and clinical profile. Notably, CD8+T-cell subsets were important in driving patient stratification while B-cell markers were similarly expressed across the JSLE cohort. JSLE patients with elevated effector memory CD8+T-cell frequencies had more persistently active disease over time, and this was associated with increased treatment burden and prevalence of lupus nephritis. Finally, network analysis identified specific clinical features associated with each of the top JSLE immune-signature variables.Conclusion:Using a combined ML approach, a distinct immune signature was identified that discriminated between JSLE patients and HCs and further stratified patients. This signature could have diagnostic and therapeutic implications. Further immunological association studies are warranted to develop data-driven personalised medicine approaches for JSLE.Acknowledgments:Lupus UK, Rosetrees Trust, Versus ArthritisDisclosure of Interests:George Robinson: None declared, Junjie Peng: None declared, Pierre Dönnes: None declared, Leda Coelewij: None declared, Meena Naja: None declared, Anna Radziszewska: None declared, Chris Wincup: None declared, Hannah Peckham: None declared, David Isenberg Consultant of: Study Investigator and Consultant to Genentech, Yiannis Ioannou: None declared, Ines Pineda Torra: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Elizabeth Jury: None declared

scholarly journals Estudio farmacogenómico en Trastorno Límite de Personalidad.

2013 ◽  
Vol 71 (1-4) ◽  
pp. 58-64
Author(s):  
Hernán Silva ◽  
Patricia Iturra ◽  
Aldo Solari ◽  
Juana Villarroel ◽  
Sonia Jerez ◽  
...  
Keyword(s):  
Overt Aggression ◽  
Overt Aggression Scale

Antecedentes: Las conductas agresivas e impulsivas han sido asociadas con disfunciones del sistema serotoninérgicocentral. Polimorfismos del transportador de serotonina, de la triptófano hidroxilasa (TPH1) y de los receptoresserotoninérgicos 5HT1B y 5HT2C han sido vinculados a agresión e impulsividad. Varios estudios en depresiónmayor han demostrado que el alelo corto (S) del promotor del gen transportador de serotonina se asocia a una peorrespuesta a los inhibidores selectivos de la recaptación de serotonina (ISRS). Material y métodos: En este estudiose investigó la asociación entre la respuesta de la impulsividad al tratamiento con fluoxetina y polimorfismos deltransportador de serotonina, TPH1 y de los receptores 5HT1B y 5HT2C, en 49 pacientes con trastorno límite depersonalidad. Resultados: Los pacientes con el genotipo L/L del promotor del gen transportador de serotonina,evaluados mediante la Overt Aggression Scale-Modified (OAS-M), tuvieron una respuesta a fluoxetinasignificativamente mejor que los portadores del alelo S. No se encontró asociación entre la respuesta a fluoxetina ylos genotipos de TPH1 y de los receptores 5HT1B y 5HT2C. Conclusiones: Este es el primer estudio en el que seevalúa la asociación entre estos polimorfismos y la respuesta anti-impulsiva a la fluoxetina en pacientes con trastornolímite de personalidad. El alelo S puede representar un factor común de peor respuesta a los ISRS en enfermedadesasociadas a una disfunción serotoninérgica. (Rev. Neuropsiquiatría 2008; 71: 58-64).

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