Background Most people with psychotic disorders will never commit an act of violence. However, the risk of violence committed by people with schizophrenia is higher than the general population. Violence risk is also known to be highest during the first episode of psychosis compared to later stages of illness. Despite this, there have been no comprehensive reviews conducted in the past 10 years examining rates of violence during FEP. We aimed to provide an updated review of the rate of violence in people with FEP. Study Design Meta-analytical techniques were used to identify pooled proportions of violence according to severity (less serious, serious, severe) and timing of violence (before presentation, at first presentation, after presentation to services). Study Results Twenty-two studies were included. The pooled prevalence was 13.4% (95% CI [9.0%–19.5%]) for any violence, 16.3% (95% CI [9.1%–27.4%]) for less serious violence, 9.7% (95% CI [5.4%–17.0%]) for serious violence and 2.7% for severe violence, regardless of time point. The pooled prevalence of any violence was 11.6% (95% CI [6.8%–18.9%]) before presentation, 20.8% (95% CI [9.8%–38.7%]) at first presentation and 13.3% (95% CI [7.3%–23.0%]) after presentation to services. Conclusion Overall, rates of violence appear to be lower in more recent years. However, due to the high between-study heterogeneity related to study design, the findings must be interpreted with consideration of sample characteristics and other contextual factors. The prevalence of violence remained high at all-time points, suggesting that more targeted, holistic, and early interventions are needed for clinical FEP groups.

中文翻译：

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系统回顾和荟萃分析：首发精神病 (FEP) 期间的暴力发生率

背景 大多数精神障碍患者永远不会实施暴力行为。然而，精神分裂症患者实施暴力的风险高于一般人群。众所周知，与疾病后期相比，精神病首次发作期间的暴力风险最高。尽管如此，过去 10 年并未对 FEP 期间的暴力发生率进行全面审查。我们的目的是对 FEP 患者的暴力发生率进行最新审查。研究设计元分析技术用于根据暴力的严重程度（较不严重、严重、严重）和暴力发生时间（就诊前、首次就诊、就诊后）确定暴力的汇总比例。研究结果 纳入了 22 项研究。任何暴力行为的汇总发生率为 13.4% (95% CI [9.0%–19.5%])，不太严重的暴力行为为 16.3% (95% CI [9.1%–27.4%])，9.7% (95% CI [5.4%]) –17.0%]) 严重暴力和 2.7% 严重暴力，无论时间点如何。任何暴力行为发生前的汇总发生率分别为 11.6% (95% CI [6.8%–18.9%])、首次发生时的 20.8% (95% CI [9.8%–38.7%]) 和 13.3% (95% CI [7.3])。 %–23.0%]）在向服务部门介绍后。结论 总体而言，近年来暴力发生率似乎较低。然而，由于与研究设计相关的研究间高度异质性，必须考虑样本特征和其他背景因素来解释研究结果。暴力发生率在任何时间点都居高不下，这表明临床 FEP 群体需要更有针对性、整体性和早期的干预措施。