Leslie Citrome, M.D., M.P.H., Acting Program Director
Linda Kline, RN, CSMS, Program Administrator

Along with other schizophrenia research, the relationship between genetics and violent behavior in patients with schizophrenia is also being explored. The catechol O-methyl-transferase (COMT) gene shows a common polymorphism that is associated with a large variation of the enzyme (COMT) activity. Preliminary results indicate that this polymorphism is associated with violent behavior. This work is done in collaboration with Herbert Lachman, MD (Albert Einstein College of Medicine).

In addition, we also are conducting neuroimaging studies in violent and impulsive patients with schizophrenia. Diffusion tensor imaging (DTI) is a relatively new neuroimaging method that provides information on the diffusion of water in the brain. This information provides a proxy measure for the integrity of brain myelin, which facilitates information transfer from one part of the brain to the other. Recently, we found that white matter disruption in inferior frontal regions was associated with impulsive and aggressive behavior in men with schizophrenia (Hoptman et al., 2002). We are now pursuing this finding in an NIMH-funded study at NKI with Matthew J. Hoptman, PhD, as the Principal Investigator. The co-investigators on this study at NKI include Karen Nolan, PhD, Leslie L. Citrome, MD, MPH, Jay Nierenberg, MD, PhD, David Guilfoyle, PhD, Babak A. Ardekani, PhD, Jan Hrabe, Ph, and Jan Volavka, MD, PhD. We also are pursuing functional MRI studies to examine the relationship between cerebral blood flow and cognitive function in aggressive and impulsive patients with schizophrenia, as well as structural MRI studies to examine the relationship between regional brain volumes and the same kinds of behaviors.

NKI has an in-house 24 bed Clinical Research and Evaluation Facility (CREF), of which twelve beds are dedicated to the study of aggression and violence in schizophrenia and other disorders. The unit is equipped with a video monitoring system that is used to detect aggressive incidents and to identify their behavioral and environmental antecedents. We also use interview methods to gather information about the patients' reasons for aggressive behavior. This information is then used, in combination with the analyses of the video recordings, to classify aggressive incidents. Other ongoing research projects are investigating psychological, neurocognitive, and genetic correlates of aggression, as well as psychopharmacological interventions to reduce aggressive behavior

For further information, contact Linda Kline at