Answers and correlations between mental disorders and social aggression. A review
FOTIADOU A., PRIFTIS F., KYPRIANOS S.

Aggressive behaviour, violent and criminal acts tend to increase and cause apprehension in developed societies. Aggression and violence are encountered in many clinical situations. Any set of conditions that generate increased aggressive impulses in the context of diminished control may lead to violent acts. Situations with combinations of factors include toxic and organic states, developmental disabilities, acute psychosis, conduct disorder, and overwhelming psychological and environmental stress. In addition, self- destructive and aggressive acts are closely correlated on the basis of biological and epidemiological data. Individuals that attempt suicide are usually young women. Individuals that commit suicide are often men of middle or advanced age. On the other hand, people with aggressive or destructive behavior are usually young and male.

The characteristics of the aggressive individual are related to social and demographic data, characteristics of childhood, psychopathological characteristics, biological factors and a history of violent or self- destructive behavior. The early exposure of the child to violent acts, mainly in the family milieu, probably confers a model for problem-solving through violent behaviors, which are adopted later in life. As far biological factors are concerned, the role of the serotoninergic system is considered as the most important.

However, any predictor of aggressiveness is merely a guideline for the possibility of an increased risk for violence, and many potentially violent people do not fit to any predictors.

According to DSM-IV criteria, the following disorders have been associated with violent and aggressive acts: mental retardation, cognitive disorders, psychotic disorders, mood disorders, conduct disorder, personality disorders, axis V conditions. Generally speaking, the likelihood of aggressive behavior increases, when the individual becomes decompensated psychologically and also when the onset of a mental disorder is rapid. Episodic decompensation may occur in those who ingest large quantities of alcohol; more than 50% of people who commit criminal homicides and who engage in aggressive behavior are reported to have imbibed significant amounts of alcohol immediately beforehand.

Certain subgroups of people with a mental disorder such as schizophrenia, mania, depression, who are not compliant with treatment and who lack insight, often show aggressive behavior.

General community attitude toward the psychiatric patient is often fear and repulsion. There is often intense prejudice and the main worry is related to the ostensible unpredictability and dangerousness of the mentally ill.

The Psychiatric Reform constitutes a collective endeavor by the government, psychiatrists and other mental health professionals and the community for the definitive comprehensive care of the chronic psychiatric patient, in order for him to remain active citizen, in his family milieu, with autonomy, work and complete incorporation in the community.

The Psychiatric Reform is based on the idea of social solidarity and support. The term “social support” refers to the mechanism through which interpersonal relationships protect people from the detrimental effects of stress. Generally speaking, when there is a strong social supportive system, vulnerability to mental illness is low and probability of recovery from a disorder, if it occurs, high.

The program "Psychargos" is a lasting, ten-year evolvement program. The target of this program is to gradually cover all needs, in the sector of mental health on a national scale. Also, it aims at the decongestion of Psychiatric Hospitals, by rehousing chronically mentally ill to all kinds of community living arrangements. This is an innovative program for Greece with the final target of total deinstitutionalization.

The philosophy of community psychiatry is that all people are entitled to funtamental human rights, in order to fight stigma, social exclusion, institutionalization and the resulting cognitive decline. They must have a right to difference, social protection and proper living facilities.

The materialization of this program secures chronically mentally ill and provides mental health professionals and the community an affirmation of cultural values and noble feelings.

Key words: Aggression, mental disorder, community, social support.