The symptoms of schizophrenia are so extensive that only a few differences can list all the symptoms. It is because this disease has many forms and varieties. Moreover, each person’s psyche is unique, so it is difficult to predict how exactly it will behave in the case of mental pathology. Aggression in schizophrenia is not among the most common signs. Let’s talk more about it in this article.

Aggression in Schizophrenia



Schizophrenia is a chronic endogenous mental illness that affects a person’s thinking. It is relatively common and occurs in about one person in 100 regardless of gender, nationality, country of residence, and other characteristics. Most often, the disease manifests itself at a young age but can develop in old age and schoolchildren.

Schizophrenia is still poorly understood. There is a lot of data on it, but scientists still have no idea of the true causes of its development. Also, doctors cannot give a 100 percent prognosis regarding the course of each case. The disease is so individual and unique that it is difficult to conclude. Some patients have only one attack their whole life, so they live like any other person. Others, on the other hand, degenerate quickly and lose their personality in just a few years.

However, the unpredictability and complexity of schizophrenia do not rule out patterns, which doctors have identified by studying patients’ medical histories. There are two types of symptoms of this disorder, negative and positive.

The former is associated with a passive state of mind. The person’s behavior is characterized by apathy, indifference, lack of willpower, interest, and withdrawal. The patient estranges from loved ones, breaks off social contacts, quits school, work, and stops doing the things that used to bring pleasure.

See Also: What is Psychopathic Schizophrenia?

Positive (productive) symptoms are indicative of an active psyche. In this case, such symptoms as delusions and hallucinations are observed. They, in turn, are divided into many subtypes. At the same time, not every form of schizophrenia patient is disturbed by such signs. Their presence increases the likelihood that a schizophrenic disorder develops.

Information about hallucinations is very subjective since it is recorded from the patient’s words.

Aggression as a symptom of schizophrenia is difficult to categorize. On the one hand, aggressive behavior indicates mental activity. However, it can also be in adverse symptomatology.

Suppose the person does nothing or is engrossed in some strange activity. His relatives try to interrupt his activity, for whom the behavior of the loved one seems strange. He may respond aggressively to his relatives in a state of apathy.

But after a sudden outburst of aggression, they will likely close down and become quiet again. It is not by chance that psychotherapists consult with the patient’s environment on rules of communication with the schizophrenic person.



The term “aggression” is treated ambiguously in science. It cannot be called “bad” or “good. In general, this emotion is essential, along with fear and longing, and it does not arise by chance but with a specific purpose. In the moment of danger, it is a source of energy to escape or attack.

The human brain has evolved over 3.2 million years. At the same time, scientists estimate that consciousness appeared in us about 50-70 thousand years ago. Our brain, with all its survival instincts, is designed for us to live on the savannah, hunt, and roam from one place to another.

However, with the help of civilization, we have, in a sense, overtaken evolution. Our biology lives by the principles it has developed over millions of years that have ensured our survival. But in the civilized world, the instinct of self-preservation is not as important as in the wilderness. As a result, we suppress some of our emotions, including anger and aggression, because that is the social norm.

The concept itself is neither positive nor negative. In ordinary life, aggressive behavior appears within the mental norm. So, having heard an insult to his address, a person, as a rule, also insults the opponent and, when attacked – defends.

The level of aggression increases under the influence of external and internal factors. The former include other people and various domestic situations. The latter may include various mental illnesses.


Aggression in Schizophrenia

In schizophrenia, aggression is often a consequence of the patient’s internal condition rather than external influences, although the latter can also provoke it. Sometimes, if it is characterized by a spiteful attitude toward the world, suspiciousness, and mania, it is considered a separate syndrome of schizophrenic disorder.

Aggression occurs not only in schizophrenia but also in depression, manic psychosis, and bipolar affective disorder.

Aggression arising against a background of mental pathologies has an unclear genesis. If schizophrenia is unpredictable, the same judgment is proper for most symptoms. There is essential statistical data showing that people with schizophrenia exhibit aggressive behavior 6.5 times more often than healthy people. And we are talking about men. Women with schizophrenia are aggressive 15 times more often than women without mental disorders.

But the scientists emphasize that aggression in schizophrenia is much rarer than in alcoholism, which destroys the cognitive functions suppressing aggressive emotions. However, in this context, there is one more question that is connected with the tendency of schizophrenic patients to abuse alcohol and drug addiction.

In other words, this topic is only being studied, and it is impossible to say people with schizophrenia are dangerous to society unequivocally. By the way, such patients suffer from violence 14 times more often than they commit it. Forced hospitalization of the patient, as a forced measure dictated by the aggressive behavior of the person, is used not so often. In most cases, if he complies with the doctor’s recommendations, the patient can have contact with other people without harming themselves.


Risk factors

An aggressive reaction to external stimuli, i.e., to actions and words of other people, is rarely observed in people with schizophrenia. The key risk factors are the internal conditions of the patient. These include:

  • Delusions, predominantly delusions of persecution;
  • Peremptory hallucinations in which the patient is given orders by someone else;
  • Violent tendencies, cases of aggressive behavior in the patient’s history which lead to violation of the law;
  • Asocial lifestyle, alcoholism, and drug addiction.

Complete lack of treatment is also a risk factor. Seizures and remissions characterize almost all forms of schizophrenia. When the disease worsens, predominantly active symptoms are observed, and negative symptoms are seen in the patient’s behavior before the onset of exacerbation. If the person is treated, takes medications, and is engaged in preventing attacks, the probability of prolonged remission increases.

5-10% of homicide charges in Western countries are against people with schizophrenic spectrum disorders.

In cases where the patient ignores the doctor’s recommendations, exacerbations occur more frequently. And each new attack is accompanied by more and more signs. Frequent hospitalizations are usually accompanied by more aggressive behavior. It is usually the reason for the compulsory treatment.


Self-aggression in schizophrenia

Two types of aggressive behavior can be classified as hetero-aggression or self-aggression. The first type is aggression toward the outside world, including people, animals, or inanimate objects. Self-aggression is anger directed at oneself. Suicidal thoughts and attempts at suicide can be a result. Sometimes, the patient may engage in self-harm while not being aware.

The fact that schizophrenia increases the risk of suicide is scientifically proven. It is typically 32 times higher than in the general population. Approximately 30% of schizophrenic patients have attempted suicide at least once. At the same time, about 10% of them are completed. It is not uncommon for patients to choose subtle and cruel ways to end their lives. For example, they may lie down in a snowdrift to freeze to death or place a heavy object down their throat to suffocate.

In this case, much of the responsibility falls on the patient’s loved ones. They should not ignore not only the schizophrenic’s suicidal attempts but also his utterances in which he says he intends to kill himself. Sooner or later, if this kind of thing is not stopped, he will do it.