Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Schizophrenia-Spectrum Disorders and Aggression

Schizophrenia Res; ePub 2017 Oct 25; Blanco, et al

As a whole, those with schizophrenia-spectrum disorders (SSD) had higher odds of aggression than those with bipolar disorder (BD), according to a recent study. However, after subdividing these groups, schizophrenia had higher odds of aggression than BD with a recent manic episode and lower odds of aggression than BD with a recent mixed episode. A retrospective study was conducted using data from 3,322 patients who were evaluated at emergency psychiatric settings. The data included demographic information, variables related to aggression towards people or property in the past 6 months, and other factors that could potentially impact the risk of aggression. Researchers found:

  • An initial multivariate regression analysis showed that SSD had 3.1 times the odds of aggression, while BD had 2.2 times the odds of aggression compared to unipolar depression.
  • A second regression analysis including bipolar subtypes showed, using unipolar depression as the reference group, that BD with a recent mixed episode had an odds ratio (OR) of 4.3; schizophrenia, OR of 2.6; and BD with a recent manic episode, OR of 2.2.


Blanco EA, Duque LM, Rachamallu V, Yuen E, Kane JM, Gallego JA. Predictors of aggression in 3,322 patients with affective disorders and schizophrenia spectrum disorders evaluated in an emergency department setting. [Published online ahead of print October 25, 2017]. Schizophrenia Res. doi:10.1016/j.schres.2017.10.002.

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