Effects of Violence Trajectories on Treatment Outcomes in Schizophrenia Spectrum Disorders

J Nerv Ment Dis. 2026 Jan 1;214(1):13-17. doi: 10.1097/NMD.0000000000001862. Epub 2025 Dec 29.

Abstract

Introduction: The relationship between violence and schizophrenia spectrum disorders (SSDs) is complex and poorly understood. Moreover, violence takes different trajectories, depending on its onset relative to that of the illness. However, the effect of such trajectories on the illness is not fully understood in nonforensic populations.

Methods: Two hundred twenty-three participants with SSD were recruited and divided into different violence subgroups using the Brown-Goodwin scale. Psychotic, affective, cognitive, and functional outcomes were measured.

Results: Subgroups only significantly differed in psychotic outcomes, such as paranoia (p=.044), measured by the Symptoms Checklist Scores (SCL-90). Pair-wise analysis revealed that those with childhood and adulthood violence displayed significantly higher paranoia, compared with the nonviolent group (p=.015). However, this was not significant after correcting for multiple comparisons.

Conclusions: Different violence trajectories are associated with different symptomatic outcomes in SSD. This suggests an interplay between violence and psychosis, which is important for comprehensive treatment approaches.

Keywords: Schizophrenia; psychosis; violence.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paranoid Disorders / psychology
  • Psychotic Disorders* / psychology
  • Psychotic Disorders* / therapy
  • Schizophrenia* / epidemiology
  • Schizophrenia* / therapy
  • Schizophrenic Psychology
  • Treatment Outcome
  • Violence* / psychology