Clinical and neurodevelopmental correlates of aggression in early psychosis

Pilar Lopez-Garcia, Stefania Ashby, Pooja Patel, Katherine M. Pierce, Monet Meyer, Adi Rosenthal, Madison Titone, Cameron Carter, Tara Niendam

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Although mental illness accounts for only 4% of aggressive behavior in the general population, there remains a modest association between aggressive behavior and psychotic disorders, particularly in the early stages of the illness. However, little is known about the specific factors associated to this increased risk. Aims: The present study aims to assess the rates, characteristics and risk factors of aggressive behavior in first episode psychosis patients (FEP). Method: We conducted a retrospective chart review of 449 FEP patients recruited from an outpatient early psychosis clinic. Aggressive behavior and clinical information were rated based upon information gathered from the chart review of data collected at baseline and after 6 months of follow-up. Results: Rates of aggressive behavior were 54.3% in FEP patients. Aggressive behavior was significantly associated with higher rates of history of birth complications, neurodevelopmental delays, learning difficulties, alcohol use disorders, and the clinical domain of poverty symptoms. In addition to aggressive behavior, 16.7% of FEP patients exhibited suicidal ideation or behaviors and 11.4% exhibited non-suicidal self-injurious behavior (NSSIB). In contrast to baseline, aggressive behaviors at 6 months follow up were almost entirely absent. Conclusions: Patients at early stages of psychosis have high rates of aggressive and suicidal behavior prior to contact with clinical services. Neurodevelopmental adversities, alcohol use disorders and poverty symptoms are associated to higher risk of aggression in early psychosis. Participation in early psychosis specialty care resulted in a dramatic reduction in aggressive behavior.

Original languageEnglish (US)
Pages (from-to)171-176
Number of pages6
JournalSchizophrenia Research
StatePublished - Oct 2019


  • Aggression
  • Early psychosis
  • First episode psychosis
  • Neurodevelopment
  • Self-harm

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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