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Violence declines with medication use in some with schizophrenia
Date:6/30/2008

DURHAM, NC Some schizophrenia patients become less prone to violence when taking medication, but those with a history of childhood conduct problems continue to pose a higher risk even with treatment, according to a new study by researchers at Duke University Medical Center.

"This is the first large randomized controlled study to compare the effectiveness of several commonly-prescribed medications for schizophrenia on reducing community violence," said Jeffrey Swanson, professor in psychiatry and behavioral sciences and the study's lead author. "Serious violent behavior is not frequent among people with schizophrenia, but when it does occur, the results can be costly and tragic."

The study found that violence declined significantly when patients took antipsychotic medications as prescribed, but only among patients whose prior risk for violence could be linked to psychotic symptoms.

The researchers identified a subgroup of schizophrenia patients with a history of childhood conduct problems who were more likely to be violent at the beginning of the study. Among these patients, violence was not strongly related to psychotic symptoms, and did not significantly decline with adherence to prescribed antipsychotic medication during the six-month study period.

The new results, which are from the National Institute of Mental Health's Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, are published in the July issue of The British Journal of Psychiatry.

"In the past, we've not understood very well why a small proportion of patients with schizophrenia become seriously violent, while most do not--and why medication seems to prevent violent behavior in some and not others," said Marvin Swartz, professor of psychiatry and coauthor of the study. "These findings tell us that people with schizophrenia may behave violently for reasons not directly related to their mental illness. If that's the case, t
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Contact: Melissa Schwarting
melissa.schwarting@duke.edu
919-660-1303
Duke University Medical Center
Source:Eurekalert

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