The relationship between violence and the clinical features, insight and cognitive functions of patients with schizophrenia.

Objective: We aimed to investigate factors associated with violent behavior in schizophrenia and to clarify the relationship between violent behavior and insight and cognitive functions. Method: 68 patients diagnosed with schizophrenia were separated into two groups that included patients with a history of violent behavior (n = 30) and those patients without prior history of violent actions (n = 38). The Positive and Negative Syndrome Scale (PANSS), Buss-Perry Aggression Questionnaire, Schedule for Assessing the Three Components of Insight, California Verbal Learning Test (CVLT), Trail Making Test, Wisconsin Card Sorting Test, and Stroop Test were administered to patients in each group. Results: Male gender, the number of hospitalizations, noncompliance with the treatment, alcohol and substance abuse, the number of suicide attempts, PANSS positive score, PANSS general psychopathology score and PANSS total score were significantly higher in patients with schizophrenia with a history of violent behavior, relative to the non-violent patients. The mean score for the delayed response sub-section of the CVLT was lower among patients with a history of violent behavior. Noncompliance with treatment (OR:5.927, p=0.041), alcohol and substance abuse (OR:21.089, p=0.000), and total PANSS score (OR:1.053, p=0.011) were identified as significant predictive factors for violent behavior in patients with schizophrenia. Conclusion: The absence of insight and executive function impairment are core symptoms of schizophrenia and do not appear to be associated with violent behavior. Memory impairment may be associated with violent behavior in patients with schizophrenia. Noncompliance with medical treatment, alcohol and substance abuse, and the severity of positive symptoms are the most significant factors for predicting violence behavior in patients with schizophrenia.