Citation

Brucato G, Appelbaum PS, Masucci MD, Rolin SA, Wall MM, Levin M, Altschuler R, First MB, Lieberman JA, Girgis RR. Neuropsychopharmacology 2019; 44(5): 907-914.

Affiliation

The New York State Psychiatric Institute/Columbia, University Medical Center, New York, NY, USA.

Copyright

(Copyright © 2019, Nature Publishing Group)

DOI

10.1038/s41386-018-0304-5

PMID

30591713

Abstract

In a previously reported longitudinal study of violent ideation (VI) and violent behavior (VB) among 200 youths at clinical high-risk (CHR) for psychosis, we found that VI, hitherto underinvestigated, strongly predicted transition to first-episode psychosis (FEP) and VB, in close temporal proximity. Here, we present participants' baseline characteristics, examining clinical and demographic correlates of VI and VB. These participants, aged 13-30, were examined at Columbia University Medical Center's Center of Prevention and Evaluation, using clinical interviews and the structured interview for psychosis-risk syndromes (SIPS). At the onset of our longitudinal study, we gathered demographics, signs and symptoms, and descriptions of VI and VB. One-third of participants reported VI (n = 65, 32.5%) at baseline, experienced as intrusive and ego-dystonic, and associated with higher suspiciousness and overall positive symptoms. Less than one-tenth reported VB within 6 months of baseline (n = 17, 8.5%), which was unrelated to SIPS-positive symptoms, any DSM diagnosis or other clinical characteristic. The period from conversion through post-FEP stabilization may be characterized by heightened risk of behavioral disinhibition and violence. We provide a preliminary model of how violence risk may peak at various points in the course of psychotic illness.

Language: en