Double prevention in outpatient forensic care: Early psychotic experiences and its relationship with aggression and antisocial personality disorder

Although there is evidence for the effectiveness of early interventions among Ultra-high risk (UHR) for psychosis, detection and intervention in forensic patients is lacking. This study aimed to establish the prevalence of UHR among this population and its relationship with aggression. Because there are indications that the relationship between prodromal symptoms and aggression might be particularly strong in antisocial personality disorder (ASPD), we specifically looked at the relationships within this group. Data were collected by using the Prodromal Questionnaire (PQ-16) and the Aggression Questionnaire (AQ), the semi-structured interview CAARMS and file study. Participants with ASPD (N = 30) and without this disorder (N = 44) were compared. Within this forensic setting, the prevalence of ultra-high risk for psychosis was significantly higher compared to regular mental health care. We found a significant relationship between prodromal psychotic symptoms and aggressive feelings (anger and hostility). In patients with ASPD, we also found a significant relation between prodromal psychotic symptoms and physical violence. This implies that patients in the prodromal phase have a higher risk to behave aggressively.