Aggression bei Schizophrenien: Prävalenz, psychopathologische und soziodemographische Korrelate

Zusammenfassung

In einer retrospektiven Untersuchung wurden alle zwischen 1990 und 1995 in der Psychiatrischen Klinik der Universität München (n = 2093) aufgenommenen Patienten mit einer schizophrenen Psychose nach ICD-9-Kriterien erfasst. Relevante soziodemographische Befunde sowie die Psychopathologie sind dabei mit Hilfe des AMDP-Protokolls erhoben worden. 292 (14 %) der Patienten wiesen dabei bei Aufnahme das Merkmal Aggression auf. Während sich Patienten mit Aggression von anderen Schizophrenen in wichtigen soziodemographischen Daten, einschließlich Alter, nicht unterschieden, zeigte die weitere Analyse, dass Männer signifikant häufiger betroffen waren, ebenso Patienten mit desorganisiertem Verlaufstyp (Hebephrenie). Psychopathologische Merkmale, die gehäuft mit Aggression einhergingen, waren Wahngedanken, zerfahrenes/inkohärentes Denken, Gereiztheit, Erregungszustände und Selbstbeschädigung bei Aufnahme. Außerdem brachen Patienten mit Aggressionen die Behandlung signifikant häufiger ab oder waren zwangsuntergebracht. Inwieweit die genannten klinischen und psychopathologischen Merkmale als Risikofaktoren für Aggression und Gewalttätigkeit bei Schizophrenien angesehen werden können, wird vor dem Hintergrund der bisherigen Literatur diskutiert.

Abstract

In a retrospective study we evaluated the patient files of all schizophrenic patients (ICD-criteria) admitted to the psychiatric hospital of the university of Munich between 1990 - 1995 (N = 2093). Relevant sociodemographic, clinical and psychopathological data as asessed by means of the AMDP protocol were studied. 292 (14 %) of patients fullfilled the criterion aggression on admission. While there were few differences concerning many sociodemographic variables including, male schizophrenics were rated significantly more often to be aggressive than female schizophrenics. With respect to schizophrenic subtype desorganized patients were most likely to be aggressive. Psychopathological symptoms significantly associated with aggression were e.p. delusional ideas and desorganized thinking. Possible risk factors for aggression in schizophrenia and clinical implications are discussed.

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