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Los rasgos psicopáticos se asocian con la esquizofrenia posterior

Olli Vaurio1, Jari Tiihonen1,2,3, Markku Lähteenvuo1

  • 1Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.

Acta psychiatrica Scandinavica
|August 26, 2025
PubMed
Resumen

Los rasgos psicopáticos, medidos por la Lista de verificación de psicopatía revisada (PCL-R), aumentan significativamente el riesgo de desarrollar esquizofrenia más adelante en la vida. Las personas con puntuaciones más altas de PCL-R mostraron un riesgo sustancialmente elevado de hospitalización por esquizofrenia.

Palabras clave:
Ciencias de la saludpsiquiatría forenseLa psicopatíaTrastornos psicóticos y esquizofreniatrastornos por consumo de sustancias

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Área de la Ciencia:

  • Psiquiatría forense
  • Psicopatología
  • La neurociencia

Sus antecedentes:

  • Los rasgos psicopáticos y la esquizofrenia comparten diagnósticos y superposiciones neurobiológicas.
  • Las investigaciones anteriores no han establecido claramente si la psicopatía predice el desarrollo posterior de la esquizofrenia.
  • Los estudios existentes muestran solo asociaciones débiles entre la psicopatía y los trastornos del eje I del DSM.

Objetivo del estudio:

  • Investigar la relación entre los rasgos psicopáticos y el riesgo subsiguiente de desarrollar esquizofrenia.
  • Examinar si las puntuaciones de la Lista de verificación de psicopatía revisada (PCL-R) predicen el desarrollo de esquizofrenia en individuos evaluados forense.
  • Analizar los resultados a largo plazo en una cohorte sometida a evaluaciones psiquiátricas forenses.

Principales métodos:

  • Datos combinados de las evaluaciones psiquiátricas forenses (1984-1993) con los registros de atención médica.
  • Se utilizaron análisis de supervivencia, incluidas las estimaciones de Kaplan-Meier y los modelos de riesgos proporcionales de Cox.
  • Siguieron a los participantes hasta 40 años, ajustando por edad, sexo, responsabilidad penal y trastorno por abuso de sustancias.

Principales resultados:

  • Las personas con puntuaciones más altas de PCL-R (11-244 y ≥25) enfrentaban un riesgo significativamente mayor de hospitalización posterior por esquizofrenia.
  • Aquellos clasificados como psicópatas (PCL-R ≥25) tenían un riesgo 2,37 veces mayor de desarrollar esquizofrenia.
  • Aproximadamente el 20% de los individuos clasificados como psicópatas desarrollaron esquizofrenia durante el período de seguimiento.

Conclusiones:

  • Las puntuaciones más altas de PCL-R están relacionadas con un mayor riesgo de desarrollar esquizofrenia en individuos no psicóticos sometidos a evaluación forense.
  • Los posibles factores contribuyentes incluyen el consumo de sustancias y los factores de riesgo subyacentes compartidos.
  • Este estudio pone de relieve una asociación significativa entre la psicopatía y el riesgo de esquizofrenia.