Aggressivity in Schizophrenia: The Risk and Confounders in a Romanian Setting

There is an increased stigma in Romania regarding schizophrenia patients, who are thought to be violent and dangerous. However, there is little research on this topic that analyzes the exact risk of aggressive behavior, especially considering the high prevalence of alcohol and substance abuse, conditions also associated with a potential risk of violent behavior. The objectives of this study were to compare aggressivity levels between patients with schizophrenia admitted to an emergency hospital and healthy individuals and to find possible risk factors. This case-control study, matched for age and gender included 50 patients hospitalized for schizophrenia and 50 healthy participants from an emergency psychiatric facility in Romania. We collected demographic data and screened for major mental disorders using the Mini International Neuropsychiatric Interview (MINI). Aggressivity levels were measured with the Buss-Perry Aggression Questionnaire (BPAQ). The CAGE questionnaire and the Drug Abuse Screening Test (DAST-10) were used to screen for alcohol and substance use disorder. The results highlighted a 3.93 times increase in aggressivity in the schizophrenia group, with the involvement of specific violent domains. Younger men with alcohol abuse had a higher risk of violent acts. Schizophrenia patients appear to present an increased risk of violence, but this must be carefully assessed and confounders considered. Public health programs are needed to increase treatment compliance and decrease alcohol and other psychoactive substances consumption.