Oakley Clare, Harris Stephanie, Fahy Thomas, Murphy Declan, Picchioni Marco
St Andrew's Academic Department, St Andrew's Healthcare, Cliftonville, Northampton NN1 5DG, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Forensic and Neurodevelopmental Sciences, 16 De Crespigny Park, London SE5 8AF, UK.
St Andrew's Academic Department, St Andrew's Healthcare, Cliftonville, Northampton NN1 5DG, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Forensic and Neurodevelopmental Sciences, 16 De Crespigny Park, London SE5 8AF, UK.
Schizophr Res. 2016 Apr;172(1-3):54-9. doi: 10.1016/j.schres.2016.01.047. Epub 2016 Feb 12.
Both childhood adversity and conduct disorder are over-represented among adult patients with schizophrenia and have been proposed as significant factors that may increase the risk of violence. It is not known how childhood adversity and conduct disorder might interact to contribute towards an increased risk of violence in schizophrenia. This study aimed to explore the relationships between childhood adversity, conduct disorder and violence among men with schizophrenia.
54 male patients with schizophrenia from a range of inpatient and outpatient mental health services were assessed for exposure to a variety of childhood adversities, conduct disorder before the age of 15 and later violent behaviour in adulthood.
Exposure to domestic violence during childhood was associated with an increased propensity to violence in adulthood. Symptoms of conduct disorder were associated both with cumulative exposure to childhood adversities and with later propensity to violence. The cumulative number of childhood adversities was associated with adult propensity to violence. This association was significantly attenuated by inclusion of conduct disorder in the model.
This is the first study to demonstrate an association between childhood exposure to domestic violence and later violent behaviour in schizophrenia. Conduct disorder may mediate the association between cumulative childhood adversities and adult propensity to violence, indicating an indirect pathway. These results indicate a complex interplay between childhood adversity, conduct disorder and later violent behaviour in schizophrenia, and suggest that there may be shared aetiological risk factors on a common developmental pathway to violence.
童年逆境和品行障碍在成年精神分裂症患者中均有较高比例，并且被认为是可能增加暴力风险的重要因素。目前尚不清楚童年逆境和品行障碍如何相互作用，导致精神分裂症患者暴力风险增加。本研究旨在探讨男性精神分裂症患者童年逆境、品行障碍和暴力行为之间的关系。
对来自一系列住院和门诊心理健康服务机构的54名男性精神分裂症患者进行评估，了解他们童年遭受的各种逆境、15岁之前的品行障碍以及成年后的暴力行为。
童年遭受家庭暴力与成年后暴力倾向增加有关。品行障碍症状既与童年逆境的累积暴露有关，也与后期暴力倾向有关。童年逆境的累积数量与成年后的暴力倾向有关。在模型中纳入品行障碍后，这种关联显著减弱。
这是第一项证明童年遭受家庭暴力与精神分裂症患者后期暴力行为之间存在关联的研究。品行障碍可能介导童年逆境累积与成年暴力倾向之间的关联，表明存在一条间接途径。这些结果表明，童年逆境、品行障碍和精神分裂症患者后期暴力行为之间存在复杂的相互作用，并表明在暴力的共同发展途径上可能存在共同的病因风险因素。
