Cognitive functions and recidivism of aggressive behavior in schizophrenic inpatients at Forensic Unit Clinic of Psychiatry in Kosovo

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Background: Schizophrenia is associated with elevated risk of aggressive behavior and poor cognitive performance. Methods: 65 male offenders, age ≥ 18, with schizophrenia, hospitalized between January 2014 and December 2015, were evaluated using Weschler Adult Intelligence Scale (WAIS), Trail Making Test (TMT A), Trail Making Test (TMT B), and Mini Mental State Examination (MMSE) tools for cognitive function, Positive and Negative Syndrome Scale (PANSS) and Psychopathic checklist- revised (PCL-R) were used to evaluate psychopathological symptomatology manifestations of schizophrenia disorder. Historical, Clinical and Risk managment-20 (HCR-20) test was used to assess the risk factors of aggressive behavior. Overt Aggression Scale (OAS) was used to asses aggressive behavior recidivism. Results: 56.9% of inpatients with schizophrenia were recidivate in aggressive behavior (≥1 incident), while 43.1% were not recidivate during the same period time. The group with recidivism of aggressive behavior showed significant poor results in WAIS (p < 0.029, F-4.441), MMSE test (p < 0.025, F-2.755), TMT A (F-4.023, p < 0.044), and TMT B (F-4.110, p < 0.047). Cognitive variables TMT A, TMT B, and MMSE were in significant correlation with risk factors for aggressive behavior. Poor executive function was a relevant factor and it significantly predicted the recidivism of aggressive behavior. Conclusion: Poor cognitive performance seems to be associated and presents a predictor factor for aggressive behavior recidivism. Cognitive remediation methods of rehabilitation present priority in treatment of inpatients with schizophrenia under mandatory treatment measure.