Aggression in Schizophrenia and its Relationship to Neural Circuitry of Urgency
Abstract
Aggression is a major societal health concern that significantly affects individuals with psychiatric disorders and their families, treating clinicians, and mental health aides, leading to substantially higher health care costs and stigmatization. Aggression can be defined as the intent to injure another individual using either physical or psychological means, and it has the potential to lead to violence when left unchecked. The Global Burden of Diseases, Injuries, and Risk Factors Study (1), which investigated mortality from causes of death, indicated that interpersonal violence accounted for 5.2% of global deaths for males and 1.6% of global deaths for females among individuals ages 15–49 years in 2010. Although the majority of individuals with psychiatric disorders are neither aggressive nor violent, a small subgroup of patients may be more violent compared with the general population; however, the overall proportion of violence that can be attributed to this subgroup is low (2). Moreover, aggressive and violent behavior have been linked to a number of factors other than psychosis, including childhood adversity (3), substance use (4), and conduct problems in childhood (5).
In a recent meta-regression of 110 studies (6) investigating 45,533 individuals with psychotic disorders, 8,439 (18.5%) were determined to be violent, with impulsivity identified as one of the key risk factors. The brain regions that play a role in impulsive behavior are a critical area for research and…
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