Week 7: Response to ‘A systematic review and meta- regression analysis of aggression during first episode of psychosis’ Flashcards
What is the main conclusion of Winsper et al.’s meta-analysis on aggression during the first episode of psychosis (FEP)?
Rates of aggression during FEP appear not to substantially alter following service contact.
Why do the authors of the response critique Winsper et al.’s conclusion?
The conclusion is not fully supported by the existing literature and contradicts a prior review of related literature.
How many studies in the meta-analysis measured aggression both before and after mental health service contact?
Four studies.
What issues do the authors raise about the meta-analysis approach in Winsper et al.’s study?
It introduces likely confounds such as local differences in population base rates of aggression, measurement error, and poor standardization of ‘service contact’.
How many of the four studies showed a significant reduction in aggression following service contact?
Two studies showed significant reductions, and one found no significant difference.
What concern is raised about Steinert et al.’s study in the meta-analysis?
It only includes patients with subsequent rehospitalizations, which likely skews the results to show increased aggression after discharge.
What previous literature findings contradict Winsper et al.’s conclusion?
Previous literature has demonstrated a robust decrease in the probability of violent offending following treatment initiation.
What do the authors recommend regarding Winsper et al.’s conclusions?
They advise skepticism in accepting the conclusions in light of the identified issues.
What organizations supported the authors’ work?
Maryland Department of Health and Mental Hygiene, Baltimore Mental Health Systems, University of Maryland, and the Passano Foundation.
