Faay and Sommer reported risk factors for aggression in a patient with a psychotic disorder. It is important to work with the patient and family to identify specific factors relevant to the patient. The authors are from University Medical Centers of Utrecht and Groningen in The Netherlands.
Patient selection: psychosis
Risk factors for aggression:
(1) history of trauma and/or victimization
(2) exposure to triggers (social rejection, discrimination, stress, etc)
(3) impulsive behavior
(4) substance abuse
(5) conduct disorder
(6) noncompliance with medications
Clozapine or olanzapine are effective in controlling aggressive behavior. Injections of a long-acting olanzapine is effective in noncompliant patients.
The risk of aggression increases with the number of risk factors present. Reducing risk factors may reduce some of the aggression.
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