UP-TO-DATE RESEARCH – Individual characteristics, severity of psychiatric symptoms, sleep quality, and violent behaviors

Category: News

Situation to date:

Violent behaviors of people suffering from schizophrenia include physical aggression, verbal aggression, anger, and hostility, which correlate with physiological changes in the brain. As a whole, physiological changes and unsatisfactory sleep quality in people suffering from schizophrenia can influence their emotional adjustment. Sleep disorders may reduce emotional control, thereby increasing the likelihood of violent behaviors. However, few studies have explored the relationship between characteristics of community patients suffering from schizophrenia and the likelihood of hostility.

The study:

A recent study, published in July by Zi‐Ting Chen and colleagues in Perspectives in Psychiatric Care, examined the influence of individual characteristics, psychiatric symptom severity, and sleep quality on violence and its subdimensions – namely physical aggression, verbal aggression, anger, and hostility – among people suffering from schizophrenia. This cross-sectional study involved 78 community individuals suffering from schizophrenia, aged 21 to 64 years, from psychiatric outpatient clinics, psychiatric day hospital, also including those who received home‐care services. People were surveyed using the self‐report Pittsburgh Sleep Quality Index, the Aggression Questionnaire and the Brief Psychiatric Rating Scale (BPRS). Descriptive statistics were used, and a multiple regression analysis was performed to investigate the influential factors for violence.

The results revealed that unsatisfactory sleep quality was a key factor for potential violent behaviors (β = 0.38, P = 0.003), explaining 21% of the variance. This was true also considering subdimensions. Unsatisfactory sleep quality (β = 0.37, P = 0.003) and violent behaviors during the preceding month (β = 0.25, P = 0.017) were associated with physical aggression, explaining 23% of the variance.

Take-home message:

Unsatisfactory sleep quality and a history of violence during the preceding month could be crucial in influencing physical aggression, verbal aggression, anger, and hostility among outpatients suffering from schizophrenia. The findings of this study can provide a reference for community healthcare staff to predict and prevent violence in this diagnostic group.


However, a causal relationship between sleep quality and violence among community patients suffering from schizophrenia could not be established. Future studies should adopt a longitudinal design to further explore this topic, also considering the differences in this special population and avoid overgeneralization.


The article full text is available at:



Full reference:

Chen ZT, Wang HT, Chueh KH, Liu IC, Yang CM. An exploration of the sleep quality and potential violence among patients with schizophrenia in community [published online ahead of print, 2020 Jul 30]. Perspect Psychiatr Care 2020; 10.1111/ppc.12589. doi:10.1111/ppc.12589


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