Week 7: A systematic review and meta-regression analysis of aggression during the First Episode of Psychosis Flashcards
What is the objective of the study?
To examine aggression during the First Episode of Psychosis (FEP) and whether this risk changes following contact with mental health services.
What method was used in the study?
Meta-analytic methods were used to estimate pooled prevalence of aggression during FEP, along with meta-regression analyses to explore heterogeneity between studies.
What were the key findings regarding aggression before and after service contact?
Pooled prevalence of ‘any aggression’ before service contact was 28% and after contact was 31%. Pooled prevalence of ‘serious aggression’ was 16% before contact and 13% after contact, with no significant change.
What is the conclusion of the study?
Rates of aggression are high during FEP, both before and after initial service contact, with no significant changes following contact.
What factors contribute to aggression during FEP?
Factors include younger age, illness course with increasing positive symptoms, and lack of treatment such as low insight before engaging with services.
What criteria were used for study selection?
Studies were included if they sampled an FEP cohort and reported the percentage of patients who engaged in offending or aggressive behavior.
How was ‘serious aggression’ defined?
As physical violence or assault against another person or committing a violent crime.
What were the rates of ‘any aggression’ and ‘serious aggression’ during FEP?
31% for ‘any aggression’ and 16% for ‘serious aggression’, with high heterogeneity among studies.
What were the findings regarding aggression before and after service contact within the same cohorts?
No significant differences in aggression rates were found before and after service contact.
Which factors influenced aggression prevalence in the study?
Factors like assessment tools, reporting method, study time frame, and geographical location influenced reported aggression rates.
What are some possible reasons aggression does not decrease after service contact?
Challenges in early service engagement, involuntary admissions, staff-patient interactions, and lack of specific interventions for aggression beyond psychosis treatment.
What was a key limitation of the study?
Limited studies reported aggression both before and after service contact within the same cohort, making conclusions tentative.
What are the implications for clinical practice?
The need for structured interventions targeting aggression in psychosis, improved staff-patient interactions, and international guidelines for managing violence in psychosis.
