Violent recidivism in psychosis: mechanisms and treatment targets
Research type
Research Study
Full title
Violent recidivism in psychosis: mechanisms and treatment targets - A Pilot Study
IRAS ID
350920
Contact name
David Kelsey
Contact email
Sponsor organisation
North London NHS Foundation Trust
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Risk of violence in psychosis is a significant public health issue. The prevalence of violence in first episode psychosis is estimated to be 15%, and around 4% of the prison population has a psychotic illness. Cohort studies have identified persistent persecutory delusions, substance misuse, non-engagement with treatment and higher impulsivity as significant risk factors for risk of violence in psychosis.
Despite substantial progress in understanding the epidemiology of violence in psychosis, the underlying cognitive and neural mechanisms remain poorly understood. This gap represents a major barrier to accurate risk prediction and the development of effective interventions.Impulsivity—the tendency to act prematurely without foresight—is a robust predictor of violence in individuals with psychosis. Neuroscientific research suggests that impulsivity may result from dysfunction in fronto-striatal circuits, leading to impaired top-down cognitive control over actions. These circuits are also strongly implicated in the pathophysiology of psychosis. However, to date, no study has specifically investigated the cognitive mechanisms underlying impulsivity in psychosis and their relationship with violent behaviour.
We propose the first case-control study designed to identify cognitive endophenotypes of violent behaviour in individuals with psychotic disorders. Specifically, we will compare two groups: (i) patients with psychosis and a history of violence committed in the context of their illness (forensic group; case group), and (ii) patients with psychosis and no history of violence (non-forensic group; control group).
REC name
London - Bromley Research Ethics Committee
REC reference
25/LO/0752
Date of REC Opinion
11 Dec 2025
REC opinion
Further Information Favourable Opinion