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Impulsivity in early psychosis: A complex link with violent behaviour and a target for intervention
1Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Site de Cery, Bat. Les Cèdres, 1008 Prilly, Lausanne, Switzerland.
Summary
Impulsivity predicts violent behavior (VB) in early psychosis (EP) patients, even when considering substance abuse. Early intervention for psychotic disorders should assess impulsivity due to its link to VB risk.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Violent behavior (VB) is a significant concern in first-episode schizophrenia, impacting patients and victims.
- Understanding the mechanisms of VB is crucial for developing effective preventive treatments.
Purpose of the Study:
- To investigate the relationship between impulsivity and violent behavior (VB) in early psychosis (EP) patients.
- To examine how impulsivity interacts with substance abuse, insight, and positive symptoms in predicting VB.
Main Methods:
- Post hoc analysis of a 36-month early psychosis (EP) cohort study.
- Included 265 EP patients (aged 18-35) from a specialized treatment program.
- Utilized logistic regression, mediation, and interaction analyses.
Main Results:
- Impulsivity independently predicts VB and remains a differentiator in a multi-factorial model.
- The link between impulsivity and VB is not mediated by substance abuse.
- Impulsivity's effect on VB probability is amplified by interactions with insight and positive symptoms.
Conclusions:
- Impulsivity is a key predictor of violent behavior in early psychosis (EP).
- Early intervention strategies for psychotic disorders must include impulsivity assessment.
- Targeting impulsivity may offer a pathway for preventing VB in EP patients.
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