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Aggression in Elderly Schizophrenia Patients

A Comparison of Nursing Home and State Hospital Residents

Received March 3, 2000; revised July 5, 2000; July 31, 2000. From the Department of Psychology, Hofstra University, Hempstead, New York; the Pilgrim Psychiatric Center, West Brentwood, New York; and the Department of Psychiatry, Mt. Sinai School of Medicine, New York, New York. Address correspondence to Dr. Harvey, Department of Psychiatry, Box 1229, Mt. Sinai School of Medicine, New York, NY 10029. E-mail: pdharvey{at}compuserve.com

This study examined the role of cognitive functioning, adaptive functioning, and symptomatology in predicting aggression in institutionalized geriatric schizophrenic patients residing in either a state institution (n=56) or a nursing home (n=113). Patients were assessed with a neuropsychological battery and rated for positive and negative symptoms, social functioning, and aggressiveness. Nursing home residents were older and more cognitively and functionally impaired than institutional residents. The prevalence of verbal, but not physical, aggression was similar to findings in younger, acutely hospitalized patients in previous studies. In the hospitalized group, severity of negative symptoms was predictive of physical aggression. In the nursing home group, severity of positive symptoms was predictive of verbal aggression and self-care deficit was predictive of physical aggression. Results indicate that verbal aggression, like positive symptoms, decreases little with aging in institutionalized schizophrenic patients, and that predictors of aggressive behavior are as difficult to identify in elderly patients as in younger ones.

Key Words: Aggression • Schizophrenia • Geriatric Neuropsychiatry

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