Aggression in Psychiatry: State of the Art

Background : aggression is one of the most complex and relevant clinical challenges faced by clinicians working with the mentally ill. Despite the significance of this problem, the mechanisms of occurrence and risk factors of aggression are still not fully understood. The aim of review is to analyse modern research studying aggression and aggressive behavior in psychiatric patients, as well as the possibility of predicting aggressive behavior using modern diagnostic methods. Material and Methods: sources were searched in Elibrary.ru, PubMed, Scopus, PsychINFO, MedLine and Google Scholar databases using the keywords: ‘aggression’, ‘psychiatric disorders’, ‘mechanisms of aggression’, ‘aggression factors’. The selection included articles published in Russian and English in the last 20 years. Discussion : various approaches to the definition and classification of aggressive behavior are considered and the main hypotheses explaining its mechanisms discussed. Most of studies demonstrates a strong association between psychiatric disorders and increased risk of aggressive behavior. Aggression in psychiatric patients considered due to the interaction of a complex set of factors. Researchers assign a significant role to genetic predisposition to aggression, but its manifestation closely related to environmental influences. The important role of genetic determinants in the formation of aggression is shown, including the analysis of individual genes, genomic associations and intergenerational transmission. It also shown that aggressive behavior closely related to neurophysiological processes in the brain. Nevertheless, it requires furtherresearch for a detailed study of aggressive behavior mechanisms on the molecular, neurochemical and neuronal levels. Conclusion : the study of the mechanisms of formation and implementation of aggressive behavior is crucial in the creation of systems for the prevention of socially dangerous actions on the part of patients in relation to their environment. Further research in the field of genetics, biology and neurobiology of aggressive behavior considered as the most perspective.