Biological and Cognitive Markers of Violent Behavior in Forensic Patients With Polysubstance Use: Retrospective Evaluation
Summary
Aggressive behavior, both in the form of violence toward others (injury-inflicting or homicide) or toward oneself (suicide or self-injures) create problems of patient management, treatment and paroles.
Biological causes of violent crime were hypothesized by Eysenck (1978), who believed that criminality resulted from a nervous system distinct from that of most people.
The prefrontal cortex, regulates planning of motor acts and executive functions, which are critical for inhibitory ability and control of impulsive outburst were found to be impaired in violent subjects (Hoaken et al, 2003; Blair, 2001; Brower and Price, 2001; Filley et al, 2001; Raine et al, 2000; George et al, 2004; Dolan and Park, 2002; Stevens et al, 2003; Raine and Yang, 2006), especially in impulsive offenders murderers (Raine et al, 1997; 1998). Violence act influenced by nonplaning outboards definite as impulsive aggression (Linnoila and Charney, 1999), which one of the most important factor influenced by dangerous behavior in general (for review: Skodol, 1998, Moeller et al, 2001; Pontius, 2000; 2004; Siever, 2008).
Cholesterol and fats have many roles and may influence brain function and behavior through modification of membranes; myelin; enzyme function; absorption and transport of fat-soluble vitamins and toxins; and steroid hormones and through effects on production, reuptake, or metabolism of neurotransmitters (Boston et al, 1996).
Since 80-th a strong association was found between low cholesterol levels and violent behavior, an association that was not due to age, race, sex, or diagnosis (Mufti et al, 1998; New et al, 1999; Alvarez et al, 2000; Golomb et al, 2000; Hillbrand et al, 2000; Troisi and D'Argenio, 2006; Chakrabarat and Sinha, 2006).
Associations between violent behavior, cognitive functioning and total cholesterol level were contradicted with difference in samples and behavioral parameters: homicide, homicide attempts, rape, physical or verbal aggression, complete suicide or suicide attempts, only partially accounted for each measure of behaviors, suggesting that further investigation is warranted. Because of the inconsistencies in the available data, we studied retrospectively a group of criminal offenders with alcohol and drug use. Our analysis of lipid constituents in serum focused on TC, HDL, LDL, and TG.
Significance of the study. It is possible that cholesterol profile is a biomarker and potential predictor of violent in patients with polydrug use.
The purpose of this retrospective study is to investigate the correlations between cholesterol and cognitive profiles in psychiatric patients with violent behaviour. The demographic and criminal records, clinical characteristics, cholesterol profiles, and cognitive performance data of these patients will be will be intercorrelated.
Study Design
Time Perspective: Retrospective
Conditions
Violent Behavior
Intervention
chart review
Location
Beer-Yaacov MHC
Beer Yaacov
Israel
70350
Status
Active, not recruiting
Source
BeerYaakov Mental Health Center
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00797329
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Concurrent Review
Review of the medical necessity of hospital or other health facility admissions, upon or within a short time following an admission, and periodic review of services provided during the course of treatment.
Riots
A form of violent crowd behavior which expresses the emotional release of resentments and prejudices, usually relevant to grievances toward the social system.
Drug Utilization Review
Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.
Professional Review Organizations
Organizations representing designated geographic areas which have contracts under the PRO program to review the medical necessity, appropriateness, quality, and cost-effectiveness of care received by Medicare beneficiaries. Peer Review Improvement Act, PL 97-248, 1982.
Rem Sleep Behavior Disorder
A disorder characterized by episodes of vigorous and often violent motor activity during REM sleep (SLEEP, REM). The affected individual may inflict self injury or harm others, and is difficult to awaken from this condition. Episodes are usually followed by a vivid recollection of a dream that is consistent with the aggressive behavior. This condition primarily affects adult males. (From Adams et al., Principles of Neurology, 6th ed, p393)
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