Serum creatine phosphokinase levels and assaultive behaviour of psychotic patients

Creatine kinase (CK) and its association with aggressive behavior in patients with schizophrenia

OBJECTIVE

To study the association between the serum creatine kinase (CK) level and aggressive behavior in patients with schizophrenia.

METHOD

This retrospective study recruited 2780 Chinese patients with schizophrenia from January 2009 to December 2013 at the psychiatric inpatient units of West China Hospital. The diagnosis was made according to the DSM-IV criteria. The serum level of CK was checked.

RESULTS

Aggressive behavior was positively correlated with the serum CK level (r=0.262, p=0.000). The OR value is 8.084 when comparing the high CK group and normal CK group prior to admission. The aggressive behavior rate in the 5 times group (serum level≥1130U/L) after admission (28.2%) is higher than the rate prior to admission (16.5%).

CONCLUSION

The aggressive patients with schizophrenia displayed increased serum CK level. It may be useful to include a lab test of CK level in patients with schizophrenia and history of aggression. It would help the staff to take precautions to protect the patients and others.

Assaultive behaviour: before it happens

This paper reviews risk factors associated with assaultive behaviour. The author will look at specific risk factors to evaluate when assessing patients with an aggressive potential and he will examine patient-staff relationships that might trigger assaultive behaviour. The author believes that a better knowledge of risk factors allows us to develop preventive attitudes, and these will be discussed in the latter part of this paper.