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The British Journal of Psychiatry (2001) 179: 351-355
© 2001 The Royal College of Psychiatrists

Aggressive behaviour in patients with schizophrenia is associated with catechol-O-methyltransferase genotype

G. JONES, MRCPsych

S. ZAMMIT, MRCPsych, N. NORTON, BSc, M. L. HAMSHERE, BSc, S. J. JONES, BSc, C. MILHAM, BSc, R. D. SANDERS, PhD, G. M. McCARTHY, MRCPsych, L. A. JONES, PhD, A. G. CARDNO, PhD, M. GRAY, MRCPsych, K. C. MURPHY, MRCPsych and M. J. OWEN, FRCPsych

Department of Psychological Medicine, University of Wales College of Medicine, Cardiff

Correspondence: Dr Gaynor Jones, Department of Psychological Medicine, University of Wales College of Medicine, Cardiff, UK

Declaration of interest None.

Background Evidence exists for an association between aggression and schizophrenia. Although the aetiology of aggression is multifactorial, three studies have reported associations between polymorphisms of the catechol-O-methyltransferase (COMT) gene and aggression in schizophrenia.

Aims To replicate these findings in a larger sample using the Overt Aggression Scale (OAS).

Method A sample of 180 people with DSM—IV schizophrenia were rated for aggression using the OAS. Kruskal—Wallis and contingency table analyses were applied to the OAS results.

Results The high-activity homozygotes showed significantly higher scores of aggression, whereas the heterozygotes showed significantly lower scores. The odds ratio for aggression for the high-activity homozygotes was 2.07 (95% Cl=1.03-4.15), whereas that for the heterozygotes was 0.54 (95% Cl=0.30-1.00).

Conclusions The high-activity COMT homozygote confers a higher risk of recorded aggression in schizophrenia. Heterozygotes had a significantly lower risk, which may represent an example of heterosis/heterozygote advantage.


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