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Hostility in schizophrenia: An integrated analysis of the combined Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and the European First Episode Schizophrenia Trial (EUFEST) studies

Published online by Cambridge University Press:  23 March 2020

J. Volavka ,
R.A. Van Dorn ,
L Citrome ,
R.S. Kahn ,
W.W. Fleischhacker  and
P. Czobor
J. Volavka*
Affiliation:
Department of Psychiatry, New York University School of Medicine, New York, NY, PO Box 160663, Big Sky, MT59716, USA
R.A. Van Dorn
Affiliation:
Behavioral Health Epidemiology Program, RTI International, 3040 E. Cornwallis Road, PO Box 12194 Research Triangle ParkNC27709-2194, USA
L Citrome
Affiliation:
Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, 11 Medical Park Drive, Suite 106Pomona, NY10970, USA
R.S. Kahn
Affiliation:
Brain Center Rudolf Magnus, University Medical Center Utrecht (UMC), PO box 85500 GA Utrecht, 3508, The Netherlands
W.W. Fleischhacker
Affiliation:
Biological Psychiatry Division Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Anichstrasse 35 Innsbruck, 6020, Austria
P. Czobor
Affiliation:
Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Balassa u. 6Budapest, Hungary
*
*Corresponding author. Tel.: +100104069952776. E-mail address:janvolavka@gmail.com (J. Volavka).
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Abstract

Phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study enrolled a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) enrolled 498 patients. We have combined these two samples to study the effects of hostility on study discontinuation as well as to examine correlates and predictors of hostility. Individual data from 1154 patients with complete data were used for analyses. Survival analysis demonstrated that higher hostility was associated with earlier all-cause treatment discontinuation. Furthermore, regression analysis indicated that increased hostility was associated with more severe positive symptoms, lower adherence to pharmacological treatment, younger age, impaired insight, and more drug or alcohol consumption. The clinical implications of the results point to the importance of establishing therapeutic alliance while managing patient's symptoms of hostility with antipsychotics such as olanzapine combined with psychosocial interventions to improve insight and reduce substance use.

Keywords

SchizophreniaAntipsychoticsHostility
Type
Original article
Information
European Psychiatry , Volume 31 , January 2016 , pp. 13 - 19
Copyright
Copyright © European Psychiatric Association 2015

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References

Alia-Klein, N, O’Rourke, TM, Goldstein, RZ, Malaspina, DInsight into illness and adherence to psychotropic medications are separately associated with violence severity in a forensic sample. Aggress Behav 2007;33:86–96.CrossRefGoogle Scholar
Antonius, DInsight and aggression in schizophrenia. Am J Psychiatry 2005;162:2195.CrossRefGoogle Scholar
Arango, C, Barba, CA, Gonzalez-Salvador, T, Ordonez, ACViolence in inpatients with schizophrenia: a prospective study. Schizophr Bull 1999;25:493–503.CrossRefGoogle ScholarPubMed
Barnes, TRA rating scale for drug-induced akathisia. Br J Psychiatry 1989;154:672–676.CrossRefGoogle ScholarPubMed
Citrome, L, Volavka, JThe psychopharmacology of violence: making sensible decisions. CNS Spectr 2014;19:411–418.CrossRefGoogle ScholarPubMed
Coid, JW, Ullrich, S, Kallis, C, Keers, R, Barker, D, Cowden, F, et al.The relationship between delusions and violence: findings from the East London First Episode Psychosis Study. JAMA Psychiatry; 2013;70(5):465–471.CrossRefGoogle ScholarPubMed
Czobor, P, Van Dorn, RA, Citrome, L, Kahn, RS, Fleischhacker, WW, Volavka, JTreatment adherence in schizophrenia: a patient-level meta-analysis of combined CATIE and EUFEST studies. Eur Neuropsychopharmacol 2015;25:1158–1166.CrossRefGoogle ScholarPubMed
Department of Health EaW Abnormal Involuntary Movement Scale (AIMS) Washington, DC: National Institute of Mental Health; 1974Google Scholar
Ekinci, O, Ekinci, AAssociation between insight, cognitive insight, positive symptoms and violence in patients with schizophrenia. Nord J Psychiatry 2013;67:116–123.CrossRefGoogle ScholarPubMed
Fazel, S, Langstrom, N, Hjern, A, Grann, M, Lichtenstein, PSchizophrenia, substance abuse, and violent crime. JAMA 2009;301:2016–2023.CrossRefGoogle ScholarPubMed
Fleischhacker, WW, Keet, IP, Kahn, RSThe European First Episode Schizophrenia Trial (EUFEST): rationale and design of the trial. Schizophr Res 2005;78:147–156.CrossRefGoogle ScholarPubMed
Galuppi, A, Turola, MC, Nanni, MG, Mazzoni, P, Grassi, LSchizophrenia and quality of life: how important are symptoms and functioning?. Int J Ment Health Syst 2010;4:31.CrossRefGoogle ScholarPubMed
Gerlach, J, Korsgaard, S, Clemmesen, P, Lauersen, AM, Magelund, G, Noring, U, et al.The St. Hans Rating Scale for extrapyramidal syndromes: reliability and validity. Acta Psychiatr Scand; 1993;87:244–252.CrossRefGoogle ScholarPubMed
Goldsmith, LP, Lewis, SW, Dunn, G, Bentall, RPPsychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variable analysis. Psychol Med 2015;45:2365–2373.CrossRefGoogle ScholarPubMed
Hartz, SM, Pato, CN, Medeiros, H, Cavazos-Rehg, P, Sobell, JL, Knowles, JA, et al.Comorbidity of severe psychotic disorders with measures of substance use. JAMA Psychiatry; 2014;71:248–254.CrossRefGoogle ScholarPubMed
Ioannidis, JPWhy most published research findings are false. PLoS Med 2005;2:e124.CrossRefGoogle ScholarPubMed
Kahn, RS, Fleischhacker, WW, Boter, H, Davidson, M, Vergouwe, Y, Keet, IP, et al.Effectiveness of antipsychotic drugs in first episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet; 2008;371:1085–1097.CrossRefGoogle ScholarPubMed
Katona, L, Czobor, P, Bitter, IReal-world effectiveness of antipsychotic monotherapy vs. polypharmacy in schizophrenia: to switch or to combine? A nationwide study in Hungary. Schizophr Res 2014;152:246–254.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LAThe positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.CrossRefGoogle Scholar
Kay, SR, Opler, LA, Lindenmayer, JPThe Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. Br J Psychiatry Suppl 1989;155:59–65.CrossRefGoogle Scholar
Kemp, R, Hayward, P, Applewhaite, G, Everitt, B, David, ACompliance therapy in psychotic patients: randomised controlled trial. BMJ 1996;312:345–349.CrossRefGoogle ScholarPubMed
Kikkert, MJ, Schene, AH, Koeter, MW, Robson, D, Born, A, Helm, H, et al.Medication adherence in schizophrenia: exploring patients’, carers’ and professionals’ views. Schizophr Bull; 2006;32:786–794.CrossRefGoogle ScholarPubMed
Lera, CG, Herrero, SN, Aguilar Garcia-Iturrospe, E, Gonzalez Piqueras, JC, Sanjuan, AJ, Leal, CCRelationship between insight, violence and diagnoses in psychotic patients. Rev Psiquiatr Salud Ment 2012;5:43–47.Google Scholar
Lieberman, JA, Stroup, TS, McEvoy, JP, Swartz, MS, Rosenheck, RA, Perkins, DO, et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med; 2005;353:1209–1223.CrossRefGoogle ScholarPubMed
Lindenmayer, JP, Liu-Seifert, H, Kulkarni, PM, Kinon, BJ, Stauffer, V, Edwards, SE, et al.Medication nonadherence and treatment outcome in patients with schizophrenia or schizoaffective disorder with suboptimal prior response. J Clin Psychiatry; 2009;70:990–996.CrossRefGoogle ScholarPubMed
Masand, PS, Narasimhan, MImproving adherence to antipsychotic pharmacotherapy. Curr Clin Pharmacol 2006;1:47–56.CrossRefGoogle ScholarPubMed
Nolan, KA, Volavka, J, Czobor, P, Sheitman, B, Lindenmayer, JP, Citrome, LL, et al.Aggression and psychopathology in treatment-resistant inpatients with schizophrenia and schizoaffective disorder. J Psychiatr Res; 2005;39:109–115.CrossRefGoogle ScholarPubMed
Ochoa, S, Suarez, D, Novick, D, Arranz, B, Roca, M, Bano, V, et al.Factors predicting hostility in outpatients with schizophrenia: 36-month results from the SOHO study. J Nerv Ment Dis; 2013;201:464–470.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, et al.The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(Suppl. 20):22–33.Google ScholarPubMed
Simpson, GM, Angus, JWSA rating scale for extrapyramidal side effects. Acta Psychiatr Scand 1970;212(Suppl.):11–19.CrossRefGoogle ScholarPubMed
Swanson, JW, Swartz, MS, Elbogen, EBEffectiveness of atypical antipsychotic medications in reducing violent behavior among persons with schizophrenia in community-based treatment. Schizophr Bull 2004;30:3–20.CrossRefGoogle ScholarPubMed
Swanson, JW, Swartz, MS, Van Dorn, RA, Volavka, J, Monahan, J, Stroup, TS, et al.Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia. Br J Psychiatry; 2008;193:37–43.CrossRefGoogle ScholarPubMed
Swartz, MS, Swanson, JW, Hiday, VA, Borum, R, Wagner, HR, Burns, BJViolence and severe mental illness: the effects of substance abuse and nonadherence to medication. Am J Psychiatry 1998;155:226–231.Google ScholarPubMed
Tunis, SL, Faries, DE, Stensland, MD, Hay, DP, Kinon, BJAn examination of factors affecting persistence with initial antipsychotic treatment in patients with schizophrenia. Curr Med Res Opin 2007;23:97–104.CrossRefGoogle ScholarPubMed
Ullrich, S, Keers, R, Coid, JWDelusions, anger, and serious violence: new findings from the MacArthur Violence Risk Assessment Study. Schizophr Bull 2014;40:1174–1181.CrossRefGoogle ScholarPubMed
Van Dorn, RA, Desmarais, SL, Tueller, SJ, Jolley, JM, Johnson, KL, Swartz, MSDrug and alcohol trajectories among adults with schizophrenia: data from the CATIE study. Schizophr Res 2013;148:126–129.CrossRefGoogle ScholarPubMed
Victoroff, J, Coburn, K, Reeve, A, Sampson, S, Shillcutt, SPharmacological management of persistent hostility and aggression in persons with schizophrenia spectrum disorders: a systematic review. J Neuropsychiatry Clin Neurosci 2014;26:283–312.CrossRefGoogle ScholarPubMed
Volavka, JNeurobiology of violence 2 ed.Washington, DC: American Psychiatric Publishing, Inc.; 2002.Google Scholar
Volavka, J, Czobor, P, Derks, EM, Bitter, I, Libiger, J, Kahn, RS, et al.Efficacy of antipsychotic drugs against hostility in the European First Episode Schizophrenia Trial (EUFEST). J Clin Psychiatry 2011;72:955–961.CrossRefGoogle Scholar
Volavka, J, Czobor, P, Citrome, L, Van Dorn, RAEffectiveness of antipsychotic drugs against hostility in patients with schizophrenia in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. CNS Spectr 2014;19:374–381.CrossRefGoogle ScholarPubMed
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