Background: The purpose was to systematically investigate which pharmacological strategies are effective to reduce the risk of violence among patients with Schizophrenia Spectrum Disorders (SSD) in forensic settings. Methods: For this systematic review six electronic data bases were searched. Two researchers independently screened the 6,003 abstracts resulting in 143 potential papers. These were then analyzed in detail by two independent researchers. Of these, 133 were excluded for various reasons leaving 10 articles in the present review. Results: Of the 10 articles included, five were merely observational, and three were pre-post studies without controls. One study applied a matched case-control design and one was a non-randomized controlled trial. Clozapine was investigated most frequently, followed by olanzapine and risperidone. Often, outcome measures were specific to the study and sample sizes were small. Frequently, relevant methodological information was missing. Due to heterogeneous study designs and outcomes meta-analytic methods could not be applied. Conclusion: Due to substantial methodological limitations it is difficult to draw any firm conclusions about the most effective pharmacological strategies to reduce the risk of violence in patents with SSD in forensic psychiatry settings. Studies applying more rigorous methods regarding case-definition, outcome measures, sample sizes and study designs are urgently needed.

Reisegger, A., Slamanig, R., Winkler, H., Carra, G., Crocamo, C., Gosek, P., et al. (2022). Pharmacological Interventions to Reduce Violence in Patients with Schizophrenia in Forensic Psychiatry. CNS SPECTRUMS, 27(4), 388-398 [10.1017/S1092852921000134].

Pharmacological Interventions to Reduce Violence in Patients with Schizophrenia in Forensic Psychiatry

Carra G.;Crocamo C.;
2022

Abstract

Background: The purpose was to systematically investigate which pharmacological strategies are effective to reduce the risk of violence among patients with Schizophrenia Spectrum Disorders (SSD) in forensic settings. Methods: For this systematic review six electronic data bases were searched. Two researchers independently screened the 6,003 abstracts resulting in 143 potential papers. These were then analyzed in detail by two independent researchers. Of these, 133 were excluded for various reasons leaving 10 articles in the present review. Results: Of the 10 articles included, five were merely observational, and three were pre-post studies without controls. One study applied a matched case-control design and one was a non-randomized controlled trial. Clozapine was investigated most frequently, followed by olanzapine and risperidone. Often, outcome measures were specific to the study and sample sizes were small. Frequently, relevant methodological information was missing. Due to heterogeneous study designs and outcomes meta-analytic methods could not be applied. Conclusion: Due to substantial methodological limitations it is difficult to draw any firm conclusions about the most effective pharmacological strategies to reduce the risk of violence in patents with SSD in forensic psychiatry settings. Studies applying more rigorous methods regarding case-definition, outcome measures, sample sizes and study designs are urgently needed.
Articolo in rivista - Review Essay
Forensic psychiatry; Pharmacological interventions; Schizophrenia; Systematic review; Violence;
English
5-feb-2021
2022
27
4
388
398
open
Reisegger, A., Slamanig, R., Winkler, H., Carra, G., Crocamo, C., Gosek, P., et al. (2022). Pharmacological Interventions to Reduce Violence in Patients with Schizophrenia in Forensic Psychiatry. CNS SPECTRUMS, 27(4), 388-398 [10.1017/S1092852921000134].
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