Schizophrenia, Violence, Clozapine and Risperidone: a Review

  title={Schizophrenia, Violence, Clozapine and Risperidone: a Review},
  author={Brian Delal and Bernard Huckstep and Emmet P. Larkin},
  journal={British Journal of Psychiatry},
  pages={21 - 30}
There is no longer much doubt that there is a small but real association between psychosis and violence directed at others, as well as between psychosis and self-directed violence, including suicide. Schizophrenia and the affective psychoses appear to have a similar order of association with suicide (Caldwell & Gottesman, 1990), but schizophrenia is more likely to be associated with serious other-directed violence. The evidence for the effect of schizophrenia comes from three main directions… 
17 Citations

Clozapine reduces violence and persistent aggression in schizophrenia.

The reduction in violence and persistent aggression with clozapine treatment should improve the chances for integration of the schizophrenia patient into the community and provide cost savings to society.

Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia

Effective antipsychotics are needed, but may not reduce violence unrelated to acute psychopathology, but not in patients with a history of childhood antisocial conduct.

Depression and impulsivity as pathways to violence: implications for antiaggressive treatment.

Depression and impulsivity are important predictors of aggression and of differential response to antiaggressive treatment and by identifying patients who will respond better to a given medication, they will be able to develop individualized strategies for the treatment of violent behavior.

Effectiveness of atypical antipsychotic medications in reducing violent behavior among persons with schizophrenia in community-based treatment.

Treatment with atypical antipsychotic medications should be considered as an important component of violence risk management for schizophrenia patients at risk for violent behavior.

The Effect of Clozapine on the Social Behaviour Schedule in Patients Attending a Forensic Psychiatry Day Hospital

It was discovered that there was a marked difference in the hostility scores between clozapine patients and non-clozAPine patients, which scored higher in the category of other behaviours that might impede progress, particularly drug-taking.

Origins of Early Intervention in First-Episode Psychosis

The discovery of the antipsychotic drugs, the process of deinstitutionalization, and new conceptualizations of schizophrenia have been necessary precursors to current best practice treatments and have been complemented by the increasing influence of consumer and family advocacy groups, and government policy initiatives.

The role of typical and atypical antipsychotic medications in the management of agitation and aggression.

  • P. Buckley
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 1999
Typical and atypical antipsychotics are indicated for persistent aggression in psychosis when medication noncompliance is the obstacle to effective treatment.

Clozapine in Special Hospital: a retrospective case-control study

The prescription of Clozapine to patients in Special Hospital leads to a greater likelihood of discharge to other services and this difference appears to be maintained over several years and to increase with time.

A survey of clozapine prescribing for inpatients in a tertiary psychiatric hospital

Until the clinical effectiveness of clozapine augmentation strategies is proven, their use should be restricted to cases where evidence-based therapies have failed.



Violence and psychosis. I. Risk of violence among psychotic men.

The presence of mental illness probably influences the decision to remand in custody for some of these offences, but this is unlikely to explain the substantially higher prevalence of schizophrenia among men convicted of homicide and arson than would be expected in the general population of Greater London.

The criminal careers of incident cases of schizophrenia

Results confirm that women with schizophrenia are at increased risk of acquiring a criminal record, but the effect in men is for violent convictions only, and the strongest associations of criminal conviction remain those recognized in non-schizophrenic subjects.

Motives for Offending among Violent and Psychotic Men

  • P. Taylor
  • Psychology, Medicine
    British Journal of Psychiatry
  • 1985
Within the psychotic group, those driven to offend by their delusions were most likely to have been seriously violent, and psychotic symptoms probably accounted directly for most of the very violent behaviour.

Violence and schizophrenia: clozapine as a specific antiaggressive agent.

Results suggest that clozapine may have a selective antiaggressive effect in hostile schizophrenic patients and patients without aggression, and both groups were indistinguishable with respect to BPRS response.

Violence and mental disorder: Developments in risk assessment.

Preface List of Contributors 1: Toward a Rejuvenation of Risk Assessment Research John Monahan, Henry J. Steadman. 2: Anger as a Risk Factor for Violence among the Mentally Disordered Raymond W.

Substance abuse among patients with treatment-resistant schizophrenia: characteristics and implications for clozapine therapy.

A modest extent of previous or current substance abuse was observed among neuroleptic-resistant schizophrenic patients who subsequently received treatment with clozapine.

Schizophrenics kill themselves too: a review of risk factors for suicide.

This article reviews recent studies reporting suicide rates and risk factors for suicide among schizophrenic patients and discusses current issues concerning the prediction, prevention, and treatment of suicidality among persons with schizophrenia.

Mental disorder, intellectual deficiency, and crime. Evidence from a birth cohort.

  • S. Hodgins
  • Psychology, Medicine
    Archives of general psychiatry
  • 1992
It was found that men with major mental disorders were 2 1/2 times more likely than men with no disorder or handicap to be registered for a criminal offense and four times morelikely to beregistered for a violent offense.

The violent and illegal behavior of mental patients reconsidered.

Although advocates for the mentally ill assert that mental patients are inappropriately stigmatized as dangerous, research indicates that former mental patients have higher arrest rates than the

Concurrent use of clozapine and valproate in affective and psychotic disorders.

The combination of clozapine and valproate was efficacious and well tolerated in the majority of patients and major adverse effects such as blood dyscrasias or seizures were not experienced by the study population.