[Epidemiology and treatment of aggression in patients with psychotic disorders]

Aggression is a major problem within psychiatry. During the recent years, a lot of research has been done, but many clinical decisions are still not evidence-based.

This article describes three studies of the thesis 'Aggression in Psychiatry'. The overarching goal was to contribute to the current knowledge on aggression with clinically relevant results. The three studies described in this article are focused on psychotic disorders.

The first study is a survival analysis with data from a 6-year follow-up study. The second study is focused on associations between aggression and clinical factors and the effect of antipsychotics on aggression in first episode psychosis patients. The third study is a meta-analysis focused on the effectiveness of typical versus atypical antipsychotics on aggression.

The yearly incidence of aggression in patients with psychotic disorders is around 2%. Patients with symptoms such as impulsivity, but also childhood trauma are at risk for aggression. Amisulpride appears effective against aggression during the first weeks of treatment. In patients with more persistent aggression, clozapine is most effective.

Aggression is complex and heterogeneous. More research is needed, but with the findings of these three studies, we contribute to the current knowledge of aggression and treatment options.