Illness and drug modifiable factors associated with violent behavior in homeless people with severe mental illness: results from the French Housing First (FHF) program.
Prog Neuropsychopharmacol Biol Psychiatry
; 90: 92-96, 2019 03 02.
Article
em En
| MEDLINE
| ID: mdl-30423419
ABSTRACT
OBJECTIVE:
The aim of this study was to investigate the factors associated with violent behavior in a large multicenter sample of Homeless Schizophrenia (SZ) and Bipolar Disorder (BD) (HSB) subjects.METHODS:
This multicenter study was conducted in 4 French cities Lille, Marseille, Paris and Toulouse. Violent behavior was defined by at least one episode of verbal or physical violence in the last 6â¯months.RESULTS:
Overall, 675 HSB patients, mean aged 38â¯years and 82.5% men were included, 458 SZ (68.4%) and 212 BD (31.6%). During the 6â¯months before evaluation, 213 (34.3%) committed at least one physical or verbal violence. In multivariate analysis, violence has been associated with younger age (aORâ¯=â¯0.96[0.94-0.99], pâ¯=â¯.001), number of nights in the street (aORâ¯=â¯1.01[1.01-1.01]), BD diagnosis (aORâ¯=â¯1.63[1.01-2.65], pâ¯=â¯.04), higher current illness severity (CGI score) (aORâ¯=â¯1.32[1.07-1.64], pâ¯=â¯.01), higher rates of current manic episode (aORâ¯=â¯2.24[1.32-3.81], pâ¯=â¯.002), current alcohol use disorder (aORâ¯=â¯2.05 [1.33-3.15], pâ¯=â¯.001), antisocial personality disorder (aORâ¯=â¯2.51[1.55-4.07], pâ¯<â¯.001) and with antidepressant consumption (aORâ¯=â¯2.01[1.01-4.04], pâ¯=â¯.04). No specific antipsychotic or mood stabilizer has been associated with decreased rates of violent behavior, however clozapine, lithium and carbamazepine remained poorly prescribed.CONCLUSION:
In case of violent behavior in HSB subjects, clinicians should focus in priority on the treatment of mania, antidepressant iatrogenic effect and alcohol use disorder by pharmacological and non-pharmacological treatments. Clozapine, lithium and carbamazepine should be chosen as the treatments of reference in this population but may be hard to manage in some cases. The current clinical trial number is NCT01570712.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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2_ODS3
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8_ODS3_consumo_sustancias_psicoactivas
Base de dados:
MEDLINE
Assunto principal:
Esquizofrenia
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Violência
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Transtorno Bipolar
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Pessoas Mal Alojadas
Tipo de estudo:
Clinical_trials
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adult
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Female
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Humans
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Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Prog Neuropsychopharmacol Biol Psychiatry
Ano de publicação:
2019
Tipo de documento:
Article