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A systematic review and meta-regression analysis of aggression during the First Episode of Psychosis

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Winsper, Catherine, Ganapathy, R., Marwaha, Steven, Large, M., Birchwood, M. J. and Singh, Swaran P. (2013) A systematic review and meta-regression analysis of aggression during the First Episode of Psychosis. Acta Psychiatrica Scandinavica, Volume 128 (Number 6). pp. 413-421. doi:10.1111/acps.12113 ISSN 0001-690X.

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Official URL: http://dx.doi.org/10.1111/acps.12113

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Abstract

Objective
The First Episode of Psychosis (FEP) represents a period of heightened risk for aggression. However, it is not known whether this risk is significantly altered following contact with mental health services.

Method
Meta-analytic methods were used to estimate pooled prevalence of ‘any’ and ‘serious’ aggression during FEP, while meta-regression analyses were conducted to explore reasons for heterogeneity between studies.

Results
Fifteen studies comprising 3, 294 FEP subjects were analysed. Pooled prevalence of ‘any aggression’ before service contact was 28% (95% CI: 22–34) and following contact 31% (95% CI: 20–42). Pooled prevalence of ‘serious aggression’ was 16% (95% CI: 11–20) before service contact and 13% (95% CI: 6–20) following contact. Four studies reporting repeated assessments within the same cohort revealed that aggression rates did not significantly differ post and pre service contact: Odds Ratios for any aggression: 1.18 (95% CI: 0.46–2.99) and serious aggression: 0.61 (95% CI: 0.31–1.21).

Conclusion
Rates of aggression are high during FEP, both before and following initial service contact, and seem not to alter following contact. This conclusion remains tentative due to considerable heterogeneity between studies and a lack of prospective cohort studies.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Science, Engineering and Medicine > Science > Psychology
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Acta Psychiatrica Scandinavica
Publisher: Wiley-Blackwell Publishing, Inc.
ISSN: 0001-690X
Official Date: 2013
Dates:
DateEvent
2013Published
Volume: Volume 128
Number: Number 6
Page Range: pp. 413-421
DOI: 10.1111/acps.12113
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
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