Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/31666
Title: Low cholesterol and risk of violence in forensic inpatients with schizophrenia, personality disorder or dual diagnosis: same or different?
Authors: Sen, P
Waheed, M-U-N
Taylor, F
Mottram, R
Haque, Q
Blakemore, A
Kumari, V
Keywords: lipids;risk assessment;schizophrenia;secure;statins
Issue Date: 20-Jun-2025
Publisher: Cambridge University Press on behalf of European Psychiatric Association
Citation: Sen, P. et al. (2025) 'Low cholesterol and risk of violence in forensic inpatients with schizophrenia, personality disorder or dual diagnosis: same or different?', European Psychiatry, 68 (1), e87, pp. 1 - 9. doi: 10.1192/j.eurpsy.2025.10051.
Abstract: Background: Violence and suicidality are common in forensic inpatients, most commonly with schizophrenia (SZ), personality disorder (PD), or comorbid SZ and PD (dual diagnosis, DD). There are no biological markers used in risk assessment tools. Lipids may provide a useful biomarker to aid violence prediction, but the roles of diagnosis and sex remain unclear. We therefore investigated lipids in adult forensic inpatients in association with the risk of violence and suicidality by primary diagnosis and sex. Method: Anonymized data were obtained for all eligible inpatients [n = 230; 114 SZ (75 males), 77 PD (40 males), 39 DD (20 males)] who had been admitted (2002–2021) to Elysium Healthcare (UK-wide) medium/low-secure facilities on lipids, age, sex, diagnosis, medication, risk of violence and suicidality, as well as days in seclusion and on high observations due to violence. Results: Mean total cholesterol (TC) in the patient sample (4.57, s.d. = 1.09) was lower, relative to the age- and sex-corrected UK population norm (4.91 mmol/l). PD (4.46 ± 1.08 mmol/l) and DD (4.24 ± 0.82 mmol/l), compared to SZ patients (4.77 ± 1.14 mmol/l), had significantly lower TC (not explained by statin use; no effect or interaction involving sex). Lower TC had significant though small associations with more days in seclusion or high observation levels due to violence across all patients, and marginally with suicidality in females. Conclusions: A low TC-violence (towards others) link exists not only for SZ but also for PD and DD and for males and females, encouraging further enquiry into lipids as a biomarker to aid violence prediction in secure care.
Description: Data availability statement: All data supporting this work will be made freely available via Brunel University London research repository.
URI: https://bura.brunel.ac.uk/handle/2438/31666
DOI: https://doi.org/10.1192/j.eurpsy.2025.10051
ISSN: 0924-9338
Other Identifiers: ORCiD: Piyal Sen https://orcid.org/0000-0002-9537-1036
ORCiD: Fern Taylor https://orcid.org/0009-0006-4297-2942
ORCiD: Alex Blakemore https://orcid.org/0000-0003-0661-564X
ORCiD: Veena Kumari https://orcid.org/0000-0002-9635-5505
Article number: e87
Appears in Collections:Dept of Life Sciences Research Papers

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