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Monday, October 4, 2010

Medication Adherence and Violence Management in Schizophrenic Patients

The following article was written by Alexis Bonari:

Medication Adherence and Violence Management in Schizophrenic Patients

Violence is not a widespread problem among people who have been diagnosed with schizophrenia, but when it does accompany schizophrenia (about 16% of the time), it can become a significant issue. When violent schizophrenic cases arise, it can be difficult for doctors to prescribe a specific course of action because little is known about the efficacy of violence management medication in schizophrenic patients. To address this problem, Dr. Jeffrey Swanson and a team of researchers studied the effects of four different antipsychotic medications on a cohort of schizophrenic patients over a period of six months. In their research, they hoped to find out how medicated patients’ violent tendencies changed as compared to patients who refused to adhere to doctors’ medication recommendations.

Reducing Schizophrenic Violence: Predictors and Solutions

Swanson and his team found that there were several consistent factors that could predict violence in patients with schizophrenia. This information could be valuable to doctors who are trying to decide whether or not to prescribe antipsychotic medication, as not all schizophrenic patients require it. The violence predictors identified by these researchers are as follows: economic deprivation, living with family or others rather than living alone, history of childhood conduct problems, substance abuse, and history of violent victimization. Specifically, patients who had experienced childhood conduct problems were statistically unresponsive to antipsychotic medication, while others were successfully treated. A strong correlation was established between violence reduction and medication regimen adherence by patients without childhood conduct problems. Patients with negative results in psychosis tests also experienced greater success with violence management medication.

Relative Success of Medications in Violence Management

In terms of the medication itself, the four different varieties performed very similarly. However, the first-generation medication was slightly more effective than the second-generation drugs in treating the cohort of patients who adhered to their recommended medication schedule. This finding is in direct contrast to the assumption that new medications are more effective than older ones and may help doctors to make more informed choices.

The researchers found that patients who took their medication as recommended experienced a 43% decline in violent tendencies. However, the cohort of patients who did not complete the six-month medication regimen experienced only a 27% reduction in violence. The results of the study showed that, in addition to antipsychotic medication, treatment adherence and social functioning are important components of successful violence management. In order to address all angles of schizophrenic violence, interventions must be made in therapy and social support as well as in antipsychotic medication. Although medication cannot act on its own, its role has been proven valuable in schizophrenic violence management.

Bio: Alexis Bonari is a freelance writer and blog junkie. She often can be found blogging about education and scholarships for college. In her spare time, she enjoys square-foot gardening, swimming, and avoiding her laptop.

Swanson, Jeffrey W., PhD et al. “Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia.” The British Journal of Psychiatry 193 (2008): 37-43.

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Valash said...

Thank you Alexis for writing on such a touchy subject.

I appreciate the fact that you said violence is NOT widespread in people living with schizophrenia, which is a common misconception.

Also, I agree with you and your research in that not everyone with schizophrenia does not need medication. I believe there are various levels of severity in mental illness that requires some people to take medication and not others.

I thought the predictors of violent tendencies in some people living with schizophrenia were interesting. While I have looked into this topic before it was no surprise that substance abuse plays a role, as it also contributes to a lot of violence among the general population or people who do not have a mental illness as well.

It kind of surprised me that older generation medications were more effective than the newer medications. Finally, it is a relief that medication can help some people with violent tendencies. However, I believe it takes more than medication to treat anything.

Thank you again for the awareness on this topic!

Ashley Smith

Valash said...

On Tuesday, I shared this article with a support group that I facilitate. We had a great discussion on the findings in this article.

Thank you again!

Ashley Smith