Violence in inpatients with schizophrenia: a prospective study.

Accurate evaluations of the dangers posed by psychiatric inpatients are necessary, although a number of studies have questioned the accuracy of violence prediction. In this prospective study, we evaluated several variables in the prediction of violence in 63 inpatients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Nurses rated violent incidents with the Overt Aggression Scale. During hospitalization, sociodemographic variables, clinical history, neurological soft signs, community alcohol or drug abuse, and electroencephalographic abnormalities did not differ between violent and nonviolent groups. Violent patients had significantly more positive symptoms as measured by the Positive and Negative Syndrome Scale (PANSS), higher scores on the PANSS general psychopathology scale, and less insight in the different constructs assessed. A logistic regression was performed to discriminate between violent and nonviolent patients. Three variables entered the model: insight into symptoms, PANSS general psychopathology score, and violence in the previous week. The actuarial model correctly classified 84.13 percent of the sample; this result is significantly better than chance for the base rate of violence in this study. At hospital admission, clinical rather than sociodemographic variables were more predictive of violence. This finding has practical importance because clinical symptoms are amenable to therapeutic approaches. This study is the first to demonstrate that insight into psychotic symptoms is a predictor of violence in inpatients with schizophrenia.

[Cannabis and alcohol use as prognosis factors in the short-term progress of schizophrenia]. / Consumo de cannabis y alcohol como factores pronósticos en la evolución a corto plazo de la esquizofrenia.

Data from 62 schizophrenic patients (DSM III), aged 18 to 30, who were treated in the public medical system, and showed a relapse in 1987, after an one-year-follow up, were analyzed. It was observed that cannabis and alcohol use increased the probability of a relapse of schizophrenia in the follow-up period, whilst moderate alcohol use (less than 70 cc of pure alcohol/day) had no influence in the probability of relapse.

Cannabis consumption as a prognostic factor in schizophrenia.

Data were analysed from 62 schizophrenic patients between 18 and 30 years of age, treated at the community mental health centres in Navarra, who had relapsed and then completed a one-year follow-up study. Factors influencing the course of illness during follow-up were: continuing cannabis consumption; previous cannabis intake; non-compliance with treatment; and stress.