The British Journal of Psychiatry (2008) 193: 247-253. doi: 10.1192/bjp.bp.107.040345
© 2008 The Royal College of Psychiatrists
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Executive function and in-patient violence in forensic patients with schizophrenia

Rachael S. Fullam, PhD

University of Manchester, Manchester

Mairead C. Dolan, MRCPsych, PhD

University of Manchester and Bolton Salford and Trafford NHS Mental Health Trust, Manchester, UK

Correspondence: Rachael Fullam, Centre for Forensic Behavioural Science, School of Psychology, Psychiatry and Psychological Medicine, Monash University, Victorian Institute for Forensic Mental Health, Locked Bag 10, Fairfield, VIC 3078, Australia. Email: rachel.fullam{at}forensicare.vic.gov.au

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

The literature on the association between neuropsychological deficits and in-patient violence in schizophrenia is limited and the findings inconsistent.

Aims

To examine the role of executive function deficits in inpatient violence using measures of dorsolateral (DLPFC) and ventrolateral prefrontal cortical (VLPFC) function.

Methods

Thirty-three violent and forty-nine non-violent male forensic in-patients with schizophrenia were assessed using neuropsychological tasks probing DLPFC and VLPFC function and on measures of symptoms and psychopathy.

Results

There were no significant group differences in neuropsychological task performance. Higher rates of violence were significantly associated with lower current IQ scores and higher excitement symptom scores. The ‘violent’ group had significantly higher interpersonal and antisocial domain psychopathy scores. In a logistic regression analysis, IQ and the interpersonal domain of psychopathy were significant discriminators of violent v. non-violent status.

Conclusions

Personality factors rather than symptoms and neuropsychological function may be important in understanding in-patient violence in forensic patients with schizophrenia.


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