Naudts Kris, Hodgins Sheilagh
Department of Forensic Mental Health Science, Institute of Psychiatry, King's College London.
Schizophr Bull. 2006 Jul;32(3):562-72. doi: 10.1093/schbul/sbj036. Epub 2005 Dec 29.
Men and women who develop schizophrenia are at increased risk, compared with the general population, to engage in violence toward others. The reasons for this robust finding remain obscure. We undertook a review of studies comparing neuropsychological test performance, neurological soft signs, and structural brain images of persons with schizophrenia with and without a history of violence. Our search identified 17 studies. The results are inconsistent and contradictory, mainly due to varying definitions of violence, differences in sample characteristics, and the use of diverse measures to tap the neurobiological correlates of violent behavior. The results suggest, however, that among men with schizophrenia, those who have displayed a stable pattern of antisocial and aggressive behavior since childhood, as compared with those with no such history, perform better on neuropsychological tests tapping specific executive functions and more poorly on assessments of orbitofrontal functions, show fewer neurological soft signs, and display larger reductions in volume of the amygdalae, more structural abnormalities of the orbitofrontal system, more abnormalities of white matter in the amygdala-orbitofrontal system, and smaller reductions in volumes of the hippocampus.
与普通人群相比，患精神分裂症的男性和女性对他人实施暴力的风险更高。这一确凿发现的原因仍不清楚。我们对比较有暴力史和无暴力史的精神分裂症患者的神经心理测试表现、神经系统软体征和脑部结构图像的研究进行了综述。我们的检索共找到17项研究。结果并不一致且相互矛盾，主要原因在于暴力的定义不同、样本特征存在差异以及采用了多种方法来探究暴力行为的神经生物学关联。然而，结果表明，在患有精神分裂症的男性中，与无此类病史的男性相比，那些自童年起就表现出稳定的反社会和攻击行为模式的男性，在测试特定执行功能的神经心理测试中表现更好，而在眶额功能评估中表现更差，神经系统软体征更少，杏仁核体积缩小幅度更大，眶额系统的结构异常更多，杏仁核 - 眶额系统的白质异常更多，海马体体积缩小幅度更小。
