Effects of continuous care based on a mobile health platform on self-management behaviors and quality of life in patients with acute leukemia.

Schizophrenia spectrum disorders (SSD) comprise a group of chronic and severe mental illnesses characterized by disruptions in cognition, emotion, and perception. While inherent symptoms – especially delusions and hallucinations – are linked to violent behavior, not all individuals with SSD engage in violent acts. The risk factors for violence remain complex and multifactorial. Among delusions, persecutory, control, and grandiose contents are significant contributors to violent behavior (; ). Aggression in individuals with SSD can be attributed to a complex interplay of factors. Substance use disorders are a significant contributor, as they can exacerbate psychiatric symptoms and lower inhibitions, leading to impulsive and aggressive behavior (; ). In general, substance abuse can intensify delusional thinking and hallucinations. Additionally, drug abuse can impair judgment and reduce the effectiveness of antipsychotic treatments, further contributing to the risk of violence and self-harm (). Delusions, defined as fixed false beliefs not grounded in reality, are a core symptom of schizophrenia. They significantly impair an individual’s level of functionality. Persecutory delusions are associated with defensive aggression (; ; ; ). Likewise, delusions of control or command hallucinations, where the individual feels coerced into violent actions, are strongly linked to violent behavior (). Grandiose delusions, involving an inflated sense of one’s abilities or importance, potentially lead to either defensive or offensive violence () (; ). Conversely, some research found no significant connection between delusional themes and aggression (). These mixed results underscore the importance of examining the specific content of delusions when assessing the risk of violence in patients with SSD and highlight the need for more research to clarify these relationships. A systematic review conducted in 2016 specifically examined the relationship between paranoia and aggression in psychotic patients. The analysis found a significant correlation between paranoid delusions and an increased risk of aggression. According to the findings, the severity of paranoid symptoms was directly related to the likelihood of aggressive behavior, particularly when patients perceived external threats or attacks ().