P0139 - Modalities of violence in schizophrenia

Abstract

Aims:

According to a recent large-scale Swedish epidemiological study, 5 % of violent crimes are attributable to patients suffering from psychosis., We present the preliminary results of a feasibility study comparing violent and non-violent schizophrenics on underlying potential process such as impulsivity, emotionality using both, psychometrics and neuropsychological correlates.

Methods:

Male Violents subjects where selected by clinicians on their life time histories of violence and control where paired according to age. Assessment include selected neuropsychological and psychometrics tests: BPRS (Brief Psychiatric Rating Scale), PCL-R (Psychopathy Checklist-Revised), BREF (Frontal Assessment Battery), WCST (Wisconsin Card Sorting Test), Iowa Gambling Task, BIS-11 (Impulsivity Scale).

Results:

Violent's performed better in the executive functions (WCST and the BREF), showing a better use of the dorso-side prefrontal cerebral cortex.

Their less good performances in the orbitofrontal functions, (Iowa Gambling Task, BREF), show cortical abnormalities involved in the processes of decision. Lesser capacity to recognize the appropriate feelings seems more present in deliberate violence, determined by the emotional coolness and the absence of fault, than in impulsive violence.

The PCL-R identifies the defect of orbitofrontal activation as the origin of the perturbed emotional integration and the bigger impulsiveness, by the slightest capacity of inhibition of the impulsive decisions.

Conclusion:

Our results, especially when compared to literature data, show the existence of dysfunctional cerebral process in schizophrenic violent patients similar to those observed in psychopathy. They outline the need for further clinical and neuropsychological studies to identify pathophysiological processes and estimate the potential recurrence of such behaviours.