AGGRESSION IN ASIAN PATIENTS WITH FIRST-EPISODE PSYCHOSIS SWAPNA VERMA, LYE YIN POON, MYTHILY SUBRAMANIAM & SIOW-ANN CHONG ABSTRACT Aims: The aims of this study were to examine the prevalence and severity of aggression in patients with first-episode psychosis and to identify the association between aggression and sociodemographic and clinical factors. Methods: Consecutive patients with first-episode psychosis admitted to the Early Psychosis Intervention Programme, Singapore, were assessed for a history of aggressive acts. Diagnosis was confirmed using the Structured Clinical Interview for DSM-IV and psychopathology was assessed using PANSS. Results: Of the 146 patients, 63.0% had no history of aggressive acts, 13.7% demonstrated severe aggression (defined as weapon use, sexual assault or victim injury) and 23.3% had lesser aggression (all other acts of aggression). Patients with aggression had a significantly longer duration of untreated psycho- sis (DUP) than those with no history of aggression (p ¼ .01). The mean total PANSS scores did not differ significantly among the three groups. However, the General Psychopathology scores and the scores for ‘hostility’, ‘poor impulse con- trol’, ‘lack of insight and judgement’ and ‘somatic concern’ were all significantly elevated in patients with aggression (p < .05). Conclusion: The significant association between aggression and longer DUP once again reiterates the need for early detection and effective management of first-episode psychosis. Key words: aggression, psychosis, psychopathology INTRODUCTION Individuals with mental disorder are two or three times more likely to behave in a violent manner as compared with controls (Brennan et al., 2000). A large number of studies have shown increased rates of aggressive behaviour among inpatients and outpatients suffering from schizophrenia compared with the general population (Klassen & O’Connor, 1990; Shah, 1990). The relationship between violence and mental illness is highly complex, particu- larly when a psychotic patient’s inner world is distorted and his or her perception of reality is affected. Violence may also represent a response to frustration and poor impulse control, which are often seen in patients with schizophrenia. International Journal of Social Psychiatry. Copyright & 2005 Sage Publications (London, Thousand Oaks and New Delhi) www.sagepublications.com Vol 51(4): 365–371. DOI: 10.1177/0020764005060852 at Monash University on March 22, 2015 isp.sagepub.com Downloaded from