Physical Aggression and Neurologic Soft Signs in Inpatients with Schizophrenia

Abstract

Objective: The availability of practical and meaningful data is indispensable in assessment of potential aggressiveness of inpatients with schizophrenia by their clinicians. In this study we performed a comparative evaluation of inpatients with schizophrenia during the acute phase of treatment who do and do not display aggressiveness, in terms of their socio-demographic, clinical and neurological soft signs. Method: 59 patients (48 male, 11 female) diagnosed with schizophrenia and hospitalised for acute treatment were included in this study. The Socio-demographic Data Form, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impressions Scale, were applied to all patients both on the admission day and the discharge day. In order to assess the neurological soft signs, the Neurological Evaluation Scale was employed. Aggressiveness was determined via the Overt Aggression Scale(OAS). Patients who scored two or more points in the physical aggression subscale of OAS were categorised as displaying physical aggression. Results: We obzerved that schizophrenia inpatients who displayed aggressive behaviour during acute treatment had higher PANSS general psychopathological scores (61.22±15.05 for aggressive patients vs., 52.25±15.49 for nonaggressive patients), had more frequent family history of psychological disorders (63.2% for aggressive vs., 33.3% for nonaggressive patients) and underwent longer hospitalisation periods (46.04±14.96 days for aggressive vs., 32.58±14.22 days for nonaggressive patients), in comparison to those who did not. We did not see a statistically significant difference between the groups in terms of Neurological Soft Signs. Conclusion: According to the data generated in our study, it is concluded that a combined evaluation of previous periods of hospitalisation, family history in terms of frequency of appearance of psychological disorders and PANSS general psychopathological scores can be informative in assessing potential physical aggressiveness in patients with schizophrenia. Those inpatients that have high scores in all three parameters mentioned above require closer monitoring for possible display of aggressive behaviour.