Depression and violent behavior of schizophrenic patients and forensic schizophrenic patients at Galya Rajanagarindra Institute

Abstract

Background : There have been several studies in depression and violent behaviors of schizophrenia patients. Nevertheless, in Thailand, there was few research about forensic schizophrenic patients including those related between depression and violent behaviors.

Objective : To explore prevalence, relationship, and related factors of depression and violent behavior and to compare the prevalence of depression and violent behavior between schizophrenic patients with and without criminal charge at Galya Rajanagarindra Institute.

Design : Cross-sectional descriptive study.

Setting : Galya Rajanagarindra Institute.

Materials and Methods : Data were collected from 140 schizophrenia patients. The questionnaire included:

1) copying data from patient records;

2) general background;

3) Revised-Thai version of the Multi-dimensional Scale of Perceived Social Support (r-T-MSPSS);

4) The Thai version of Calgary Depression Scale for Schizophrenia (CDSS);

5) Overt Aggression Scale (OAS).

The data were analyzed by Descriptive Statistic, Chi – square test and logistic regression analysis.

Results : Forty six percent of schizophrenic patients had depression (46.4%) and 32.9% violent behavior.                The strength of relationship between depression and violent behavior was low with Phi value at 0.11. Forensic schizophrenic patients had higher likelihood of having depression and also violent behavior than those without (OR = 1.9, X2 = 2.76, P-value = 0.097 for depression and OR = 1.3, X2 = 0.55, p-value = 0.459 for violent behavior, respectively). Medication side effects (OR = 3.45, P-value = 0.002), Family’s relationship (OR = 1.68, P-value = 0.027), and Social Support (OR = 0.51, P-value = 0.007) could predict depression. On the contrary, the associated factors with violent behavior were history of taking (OR = 0.90, P-value < 0.001) and history of suicide (OR = 0.72, P-value = 0.014).

Conclusion : The prevalence’s depression and violent behavior in schizophrenic patients were 46.4% and 32.9% respectively. The associated factors with depression were medication side effects, family’s relationship, and social support whereas, the associated factors with violent behavior were alcohol and suicide. Although having
criminal charge increased the likelihood of depression and violent behavior, the magnitude was not statistically significant.