A multi-dimensional approach to the relationship between insight and aggressiveness in schizophrenia: Findings from the FACE-SZ cohort

SCHIZOPHRENIA RESEARCH

卷:204

Article

Schandrin, A.^1,14  Norton, J.¹⁵  Raffard, S.^6,15  Aouizerate, B.^1,2,16  Berna, F.^1,3  Brunel, L.^1,5  Chereau-Boudet, I^1,4  Damato, T.^1,7  Denizot, H.^1,4  Dubertret, C.^1,10  Dubreucq, J.^1,9  Faget, C.^1,11  Fond, G.¹  Gabayet, F.^1,9  Llorca, P. M.^1,4  Mallet, J.^1,10  Misdrahi, D.^1,2,16  Passerieux, C.^1,12,13  Rey, R.^1,7  Schurhoff, F.^1,5  Urbach, M.^1,12,13  Bonnet, S.⁶  Capdevielle, D.^1,6,15  Andrianariso, M.^1,5  Bazin, N.^1,12,13  Blanc, O.^1,4  Bulzacka, E.^1,5  Chesnoy-Servanin, G.^1,7  Danion, J. M.^1,3  D'Amato, T.^1,7  Deloge, A.^1,2,8  Delorme, C.^1,9  Dorey, J. M.^1,7  Fluttaz, C.^1,9  Fonteneau, S.^1,12,13  Giraud-Baro, E.^1,9  Lacelle, D.^1,4  Lancon, C.^1,11  Laouamri, H.¹  Leboyer, M.^1,5  Le Gloahec, T.^1,5  Le Strat, Y.^1,10  Metairie, E.^1,10  Offerlin-Meyer, I^1,3  Peri, P.^1,11  Pires, S.^1,4  Portalier, C.^1,10  Ramet, L.^1,12,13  Rey, L.^1,7  Roman, C.^1,9  Tronche, A. M.^1,4  Vaillant, F.^1,11  Vehier, A.^1,7  Vidailhet, P.^1,3  Vila, E.^1,2,8  Yazbek, H.^1,6  Zinetti-Bertschy, A.^1,3 

[1] Fondat Fondamental, Creteil, France

[2] Charles Perrens Hosp, Dept Adult Psychiat, F-33076 Bordeaux, France

[3] Univ Strasbourg, Strasbourg Univ Hosp, Federat Translat Psychiat, INSERM,U 1114, Strasbourg, France

[4] Auvergne Univ, Clermont Ferrand Univ Hosp, EA 7280, BP 69, F-63003 Clermont Ferrand 1, France

[5] Paris Est Univ, Pole Psychiat & Addictol Hop Univ Henri Mondor, Ctr Expert Schizophrenie, INSERM,U955,Translat Psychiat Team,DHU Pe PSY, 40 Rue Mesly, F-94000 Cereteil, France

[6] Univ Montpellier I, La Colombiere Hosp, Univ Dept Adult Psychiat, CHRU Montpellier,Inserm 1061, Montpellier, France

[7] Univ Claude Bernard Lyon 1, Vinatier Hosp, Pole Est BP 300 39-95 Bd Pinel, F-69678 Bron, France

[8] Univ Bordeaux, CNRS UMR 5287, INCIA, Bordeaux, France

[9] Alpes here Hosp, Psychosocial Rehabil Reference Ctr, Grenoble, France

[10] Univ Paris Diderot, Sorbonne Paris Cite, Louis Mourier Hosp, AP HP,Dept Psychiat,Fac Med,Inserm,U894, Paris, France

[11] St Marguerite Univ Hosp, AP HM, Dept Psychiat, Marseille, France

[12] Versailles Hosp, Dept Adult Psychiat, Le Chesnay, France

[13] Univ Versailles St Quentin En Yvelines, HandiRESP Lab, Montigny Bretonneux, UFR Hlth Sci Simone Veil,EA4047, Montigny Le Bretonneux, France

[14] Univ Hosp Nimes, Dept Adult Psychiat, Nimes, France

[15] INSERM 1061, Montpellier, France

[16] Univ Bordeaux, INSERM, U862, Magendie Neuroctr Pathophysiot Neural Plastic, F-33000 Bordeaux, France

关键词: Schizophrenia;    Insight;    Awareness;    Aggressiveness;    Hostility;   

DOI  :  10.1016/j.schres.2018.07.029

来源: Elsevier

【 摘 要 】

Background: Aggressiveness is a stigma frequently associated with schizophrenia. The role of insight as a risk factor of aggressiveness remains contradictory; mainly because single measures of these states mask their complexity and heterogeneity. Methods: This study was conducted on 666 patients aged 15 and above with a DSM-IV-TR diagnosis of schizophrenia spectrum disorder, drawn from the French national network of schizophrenia expert center database. Collected data comprised socio-demographics and standardized psychiatric assessments. Aggressiveness was evaluated using the Buss-Perry Aggression Questionnaire and insight using the Scale to assess Unawareness of Mental Disorder (SUMD) and Birchwood Insight Scale (BIS). Results: Hostility was the aggressiveness dimension the most strongly associated with SUMD insight dimensions. Patients aware of their illness were nearly twice as likely to show hostility than those seriously un-aware (OR = 1.95, 95% CI.: 1.08-3.5), but not when further adjusting for depression. Similarly, those aware of the consequences of their illness and of their symptoms were more hostile. Patients moderately aware of illness consequences had a higher risk of both anger and physical aggressiveness than those unaware (OR = 2.63, 95% CI.: 1.42-4.86, OR = 2.47, 95% CI.: 133-4.60, respectively), even when adjusting for depression for anger. Conclusion: Our study confirms that a multi-dimensional approach to insight and aggressiveness is essential to understand the types of links between these clinical states. Insight may trigger the expression of an underlying hostile tendency, maybe via depression and self-stigmatisation. This should be taken into account in therapeutic approaches to improve insight. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

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