Violent Behavior in Acute Psychiatric Inpatient Facilities

Biancosino, Bruno; Delmonte, Sara; Grassi, Luigi; Santone, Giovanni; Preti, Antonio; Miglio, Rossella; Girolamo, Giovanni de

doi:10.1097/nmd.0b013e3181bb0d6b

Cited by 58 publications

(40 citation statements)

References 70 publications

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“…This finding is consistent with findings from studies on the associations with violence at individual patient level. For example, male sex and substance use disorders have been found to be reliably associated with aggression both in individual studies [28–30] and in meta-analysis [15]. Both male sex and alcohol abuse are strongly associated with violence among mentally ill outpatients, and by non-mentally disordered people in the general community.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

et al. 2015

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BackgroundViolence in acute psychiatric wards affects the safety of other patients and the effectiveness of treatment. However, there is a wide variation in reported rates of violence in acute psychiatric wards.ObjectivesTo use meta-analysis to estimate the pooled rate of violence in published studies, and examine the characteristics of the participants, and aspects of the studies themselves that might explain the variation in the reported rates of violence (moderators).MethodSystematic meta-analysis of studies published between January 1995 and December 2014, which reported rates of violence in acute psychiatric wards of general or psychiatric hospitals in high-income countries.ResultsOf the 23,972 inpatients described in 35 studies, the pooled proportion of patients who committed at least one act of violence was 17% (95% confidence interval (CI) 14–20%). Studies with higher proportions of male patients, involuntary patients, patients with schizophrenia and patients with alcohol use disorder reported higher rates of inpatient violence.ConclusionThe findings of this study suggest that almost 1 in 5 patients admitted to acute psychiatric units may commit an act of violence. Factors associated with levels of violence in psychiatric units are similar to factors that are associated with violence among individual patients (male gender, diagnosis of schizophrenia, substance use and lifetime history of violence).

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Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

et al. 2015

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“…Females often have a better course and outcome (Addington and Addington, 2008;Grossman et al, 2006;Häfner and an der Heiden, 1999;Perkins et al, 2005), and they are less likely to suffer from substance abuse, social drift and law infringement (Biancosino et al, 2009;Cantor-Graae et al, 2001;Romm et al, 2010;Thorup et al, 2007;Walker et al, 1985). Better outcome in women was not always reported in non-Western countries (Rangaswamy and Greeshma, 2012).…”

Section: Introductionmentioning

confidence: 95%

Sex differences in first-episode psychosis and in people at ultra-high risk

Cocchi¹,

Lora²,

Meneghelli³

et al. 2014

Psychiatry Research

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“…8,9 Although its main function is to compare changes in psychopathology, studies have revealed an association between factors of this scale and aggression in hospital environments. [10][11][12][13][14] This study assessed the severity of psychopathology and investigated possible associations with aggressive behaviors in the first 24 hours after psychiatric hospitalization to define whether aggressiveness was associated with the severity of psychosis and psychomotor agitation.…”

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Aggressive behavior during the first 24 hours of psychiatric admission

Calegaro

Dotto

Freitas

et al. 2014

Trends Psychiatry Psychother.

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Objective: To investigate the association between aggression in the first 24 hours after admission and severity of psychopathology in psychiatric inpatients. Methods: This cross-sectional study included psychiatric patients admitted to Hospital Universitário de Santa Maria, in Santa Maria, southern Brazil, from August 2012 to January 2013. At their arrival at the hospital, patients were interviewed to fill in the Brief Psychiatric Rating Scale (BPRS) form, and any aggressive episodes in the first 24 hours after admission were recorded using the Overt Aggression Scale (OAS). The Mann-Whitney U test was used to compare patients according to aggressiveness: aggressive versus non-aggressive, hostile versus violent, and aggressive against others only versus self-aggressive. Results: The sample was composed of 110 patients. Aggressive patients in general had higher BPRS total scores (p = 0.002) and individual component scores, and their results showed more activation (p < 0.001) and thinking disorders (p = 0.009), but less anxious-depression (p = 0.008). Violent patients had more severe psychomotor agitation (p = 0.027), hallucinations (p = 0.017) and unusual thought content (p = 0.020). Additionally, self-aggressive patients had more disorientation (p = 0.011) and conceptual disorganization (p = 0.007). Conclusions: Aggression in psychiatric patients in the first 24 hours after admission is associated with severity of psychopathology, and severity increases with severity of patient psychosis and agitation. Keywords: Aggression, psychopathology, psychiatric emergency services, Brief Psychiatric Rating Scale. ResumoObjetivo: Avaliar a relação entre agressividade nas primeiras 24 horas após admissão e a gravidade da psicopatologia de pacientes psiquiátricos. Métodos: Este estudo transversal foi realizado no Hospital Universitário de Santa Maria, na região sul do Brasil, com pacientes admitidos entre agosto de 2012 e janeiro de 2013. Ao chegar ao hospital, os pacientes foram entrevistados para completar a Escala Breve de Avaliação Psiquiátrica (BPRS), e todos os episódios de agressão nas primeiras 24 horas após a admissão foram registrados usando a Escala de Agressividade Declarada (OAS). O teste U de Mann-Whitney foi usado para as comparações entre pacientes agressivos e não-agressivos, hostis e violentos, e agressivos contra outros apenas ou autoagressivos. Resultados: A amostra tinha 110 pacientes. Em geral, pacientes agressivos tiveram escores mais altos na escala BPRS (p = 0.002) e nos itens individuais, e exibiram mais ativação (p < 0.001) e distúrbios de pensamento (p = 0.009), mas menos ansiedadedepressão (p = 0.008). Os pacientes violentos tiveram escores mais altos para excitação (p = 0.027), comportamentos alucinatórios (p = 0.017) e alteração de conteúdo do pensamento (p = 0.020). Além disso, os pacientes autoagressivos mostraram maior desorientação (p = 0.011) e desorganização conceitual (p = 0.007). Conclusões: A agressão em pacientes psiquiátricos nas primeiras 24 horas da admissão é relacionada a ...

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Violent Behavior in Acute Psychiatric Inpatient Facilities

Cited by 58 publications

References 70 publications

Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

Sex differences in first-episode psychosis and in people at ultra-high risk

Aggressive behavior during the first 24 hours of psychiatric admission

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