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Aggressive behaviour and psychosis in a clinically referred child and adolescent sample

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Despite evidence of an increased risk of violence among adults suffering from psychosis, very little is currently known about the relationship between early onset psychosis and aggressive behaviour. We aimed to identify and examine overlaps between aggressive behaviour and psychosis in a referred child and adolescent sample to assess whether potential risk factors and other associated features of this co-occurring pattern can be identified at a young age.

Methods

Standardised item sheet data on young people referred to the Child and Adolescent Department of the Maudsley Hospital between 1973 and 2004 were used to contrast three groups: (1) aggressive-only (n = 1,346), (2) psychosis-only (n = 173), and (3) co-occurring aggression and psychosis (n = 39) on a range of comorbid symptoms and potential risk factors.

Results

Co-occurring cases presented with elevated rates of depersonalisation/derealisation, intrusive thoughts and restlessness, and were more likely to have received past treatment compared with both psychosis-only and aggressive-only cases. Although co-occurring cases resembled the psychosis-only group in many domains, including socio-demographic background and rates of emotional symptoms, they differed from ‘pure’ psychosis cases in having high levels of special educational needs, irritability, non-aggressive antisocial behaviours, as well as being more likely to be from a low social class and have increased contact with police and child care authorities.

Conclusions

Our findings suggest that it is possible to identify early risk factors for aggression in individuals with psychosis.

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Acknowledgments

We are grateful to Professor Patrick Bolton (Institute of Psychiatry and South London and Maudsley NHS Trust) for allowing access to the database. This research was supported by the Royal College of Psychiatrists Quality Network for Inpatient CAMHS (QNIC), as part of PhD funding for Farah Khalid. Tamsin Ford is supported by the Medical Research Council.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, 16 De Crespigny Park, Box Number PO46, London, SE5 8AF, UK

    Farah N. Khalid & Barbara Maughan

  2. Peninsula College of Medicine and Dentistry, Veysey Building, Salmon Pool Lane, Exeter, EX2 4SG, UK

    Tamsin Ford

Authors
  1. Farah N. Khalid
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  2. Tamsin Ford
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  3. Barbara Maughan
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Corresponding author

Correspondence to Farah N. Khalid.

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Khalid, F.N., Ford, T. & Maughan, B. Aggressive behaviour and psychosis in a clinically referred child and adolescent sample. Soc Psychiatry Psychiatr Epidemiol 47, 1795–1806 (2012). https://doi.org/10.1007/s00127-012-0480-2

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  • DOI: https://doi.org/10.1007/s00127-012-0480-2

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