Youn Sarah, Watson Amity E, Guadagno Belinda L, Murrihy Sean, Byrne Linda K, Cheng Nicholas, Cotton Sue M
Orygen, Parkville, Melbourne, VIC, Australia.
The University of Melbourne, Parkville, VIC, Australia.
Trauma Violence Abuse. 2025 Jan 6:15248380241309297. doi: 10.1177/15248380241309297.
Most people with a psychotic illness will never be violent; however, it is widely known that violence is more prevalent in this group compared to the general community, particularly during first-episode psychosis (FEP). Despite this, there is limited research into what contributes to this increased risk during FEP. The present systematic review aimed to identify whether certain risk factors are differentially associated with severity and timing of violence perpetration during FEP. The following databases were used to identify studies, up to March 8, 2024: MEDLINE, Embase, PsycINFO, CINAHL, and ProQuest. A total of 15 studies were included. Male gender, non-white ethnicity, history of violence, higher general psychopathology, and recent substance use were significantly associated with any violence, regardless of the time at which violence was committed. Serious violence was not associated with any risk factors. Higher general psychopathology was associated with any violence committed before presentation to services, while male gender was associated with violence perpetrated at service entry. Only male gender and unemployment were associated with violence committed after treatment. Based on our results, risk factors appear to vary according to the severity and timing of violence. These risk factors also overlap with those found associated with violence risk in the general community, and those correlated with the risk of psychosis. Past studies are limited in the range of risk factors studied and further work is needed to understand correlates of violence in people who have experienced FEP to inform treatment options.
大多数患有精神病性疾病的人永远不会有暴力行为；然而，众所周知，与普通人群相比，暴力行为在这一群体中更为普遍，尤其是在首次发作精神病（FEP）期间。尽管如此，关于FEP期间导致这种风险增加的因素的研究仍然有限。本系统综述旨在确定某些风险因素是否与FEP期间暴力行为的严重程度和发生时间存在差异关联。截至2024年3月8日，使用以下数据库来识别研究：MEDLINE、Embase、PsycINFO、CINAHL和ProQuest。共纳入15项研究。男性、非白人种族、暴力史、较高的总体精神病理学水平以及近期物质使用与任何暴力行为均显著相关，无论暴力行为发生的时间如何。严重暴力行为与任何风险因素均无关联。较高的总体精神病理学水平与在接受服务之前实施的任何暴力行为相关，而男性与在进入服务时实施的暴力行为相关。只有男性和失业与治疗后实施的暴力行为相关。根据我们的结果，风险因素似乎因暴力行为的严重程度和发生时间而异。这些风险因素也与普通人群中发现的与暴力风险相关的因素以及与精神病风险相关的因素重叠。过去的研究在研究的风险因素范围方面存在局限性，需要进一步开展工作以了解经历过FEP的人群中暴力行为的相关因素，从而为治疗方案提供参考。
