Prevalence of violence risk factors in people at ultra-high risk of developing psychosis: a service audit

Abstract

Background: There is little data available on the prevalence of violence risk factors in people at ultra-high risk of developing psychosis.

Aim: The aim of this study was to provide an estimate of the cross-sectional prevalence of violence risk factors in those attending a routine clinical service for people at ultra-high risk of developing psychosis.

Methods: The case notes of all 34 clients receiving treatment over a 4-week period were reviewed and all clinicians were interviewed. Information was gathered regarding gender, current violent ideation, history of violence (including convictions), expressions of concern from others, problems with alcohol or substance misuse, jealousy, suspiciousness, irritability, anger and relevant subthreshold psychotic symptoms. Information on protective factors, including treatment engagement, was also gathered.

Results: Thirty-eight per cent (n = 13) had a history of violent behaviour, 79.4% (n = 27) were thought to be currently experiencing significant levels of suspiciousness and 47.1% (n = 16) were thought to have problems with anger. Twenty-nine per cent (n = 10) had previous known convictions for violence. Two-thirds (n = 8) of those where risk of violence was identified were described as being engaged with treatment.

Conclusion: There was a high prevalence of violence risk factors in this small sample. Further research with larger samples and better methodology is urgently required to investigate risk of violence in this group and determine the contribution, if any, of subclinical psychotic symptoms.