Hostility and violence of acute psychiatric inpatients (original) (raw)
Related papers
Incidence of violent behavior among patients in Psychiatric Intensive Care Units
European Journal of Psychiatry, 2016
Background and Objectives: Both psychiatric acute units and psychiatric intensive care units (PICUs) focus on acute treatment of behavioral disturbances such as violence and aggressive threats and acts. The aim of the present study is to describe the frequency of violent behavior; such as verbal or physical threats and physical attacks, among patients admitted to psychiatric intensive care unit (PICU). In addition the relationship between the episodes of threats and/or attacks in relation to time of the day, days of the week, and their seasonal variations was explored. Methods: All violent behavior was continuously assessed at the psychiatric emergency department. Data were collected during the period from May 2010 to May 2012. Results: Patients with only one hospitalization were less violent than those who have had two hospitalizations. There was a statistically significant difference in violence among patients without formal secondary education and those who have not formal educat...
Aggressive incidents on a psychiatric intensive care unit
Psychiatric Bulletin, 2008
Aims and MethodThis study looked at patient aggressive behaviour on an Irish psychiatric intensive care unit, and whether it was related to diagnosis, patient's insight and symptomatology. Each aggressive incident was recorded throughout the patient's stay using the Staff-Observed Aggression Scale.ResultsNinety-nine individuals were admitted to the unit during the study. We recorded 82 aggressive incidents, with most occurring during the daytime and on weekdays. There was no statistical difference in BPRS scores between the aggressive and non-aggressive groups. the aggressive patient group had a lower insight score than the non-aggressive group (P < 0.05) as measured on the Schedule of the Assessment of Insight. However, when gender and verbal aggression only were included in the analysis, the difference in insight was less significant (P=0.07).Clinical ImplicationsAggression is common on a psychiatric intensive care unit. Low levels of insight in patients may increase th...
The antecedents of violence and aggression within psychiatric in-patient settings
Acta Psychiatrica Scandinavica, 2012
antecedents of violence and aggression within psychiatric in-patient settings. Objective: To systematically review the types and proportions of antecedents of violence and aggression within psychiatric in-patient settings. Method: Empirical articles and reports with primary data pertaining to violence and aggression within adult psychiatric in-patient settings were retrieved. For each study, prospective antecedent data were extracted. The extracted antecedent data were thematically analysed, and all higher-level themes were meta-analysed using rate data. Results: Seventy-one studies met the inclusion criteria, from which 59 distinct antecedent themes were identified and organised into nine higher-level themes. The higher-level antecedent theme Ôstaff-patient interactionÕ was the most frequent type of antecedent overall, precipitating an estimated 39% of all violent ⁄ aggressive incidents. An examination of the staff-patient interaction themes revealed that limiting patients freedoms, by either placing some sort of restriction or denying a patient request, was the most frequent precursor of incidents, accounting for an estimated 25% of all antecedents. The higher-level themes Ôpatient behavioural cuesÕ and Ôno clear causeÕ also produced other large estimates and were attributed to 38% and 33% of incidents overall. Conclusion: This review underscores the influence that staff have in making in-patient psychiatric wards safe and efficacious environments.
Current Psychiatry Reports, 2021
Purpose of Review We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience. Recent Findings A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Summary Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need t...
2020
Aim: The objective is to identify key predictors of violent behaviour amongst patients admitted to PICUs. Methods: A literature search was carried out in five online databases using a predefined strategy with terms relevant to the setting and population. Articles were screened based on the inclusion criteria and quality assessed using the Hawker critical appraisal tool. A thematic matrix was prepared from the final articles to highlight the pivotal predictors for violent behaviour in PICUs. Results: Initial search without duplicates retrieved 152 articles, of which 120 were excluded after screening their title and abstract. The full-text of 32 articles was read of which a total of 10 studies with 4733 participants were included in the literature review. These studies had good designs and methodological quality. The key predictors of violent incidents were a longer duration of in-patient stay, higher readmission rate, non-voluntary admission to PICUs, previous history of violence and...
Violence and its prediction at a psychiatric hospital
European Psychiatry, 2001
Aggressive behaviour in psychiatric inpatients was assessed before and after a training course for staff members. The Social Dysfunction Aggression Scale (SDAS) was used to report and assess aggressive behaviour over time, and the Staff Observation Aggression Scale (SOAS) to report and assess single aggressive incidents. In addition, the numbers of nursing staff members who were on sick leave because of injuries in the periods before and after the course were recorded and compared. No statistically significant reduction was found in the number of aggressive patients or in the number of staff members on sick leave. One interesting finding was a lower reporting on the SOAS of perceived aggressive incidents after the training course in comparison with the SDAS reports. Directed verbal aggressiveness and violence towards things were found to be predictors of violence.
Violence in a psychiatric unit
Journal of Advanced Nursing, 1978
The aim of this paper is to discuss violence in a modem purpose-built psychiatric unit, with a view to a better understanding of the associated problems of patient care and their management. The unit was built in 1965 and since then certain changes In its design have been necessary. Some modification of pliilosophy of care has also been introduced and these clunges have benefited tlie majority of patients, but a plea is made for a 'small area that is lockablc'. The paper makes a valuable contribution to the current discussions into violence in psychiatric hospitals.
Predictors of violent behavior among acute psychiatric patients: Clinical study
Psychiatry and Clinical Neurosciences, 2008
Violence risk prediction is a priority issue for clinicians working with mentally disordered offenders. The aim of the present study was to determine violence risk factors in acute psychiatric inpatients. Methods: The study was conducted in a locked, short-term psychiatric inpatient unit and involved 374 patients consecutively admitted in a 1-year period. Sociodemographic and clinical data were obtained through a review of the medical records and patient interviews. Psychiatric symptoms at admission were assessed using the Brief Psychiatric Rating Scale (BPRS). Psychiatric diagnosis was formulated using the Structured Clinical Interview for DSM-IV. Past aggressive behavior was evaluated by interviewing patients, caregivers or other collateral informants. Aggressive behaviors in the ward were assessed using the Overt Aggression Scale. Patients who perpetrated verbal and against-object aggression or physical aggression in the month before admission were compared to non-aggressive patients, moreover, aggressive behavior during hospitalization and persistence of physical violence after admission were evaluated. Results: Violent behavior in the month before admission was associated with male sex, substance abuse and positive symptoms. The most significant risk factor for physical violence was a past history of physically aggressive behavior. The persistent physical assaultiveness before and during hospitalization was related to higher BPRS total scores and to more severe thought disturbances. Higher levels of hostility-suspiciousness BPRS scores predicted a change for the worse in violent behavior, from verbal to physical. Conclusion: A comprehensive evaluation of the history of past aggressive behavior and psychopathological variables has important implications for the prediction of violence in psychiatric settings.
Violent incidents in a psychiatric intensive care unit
The British Journal of Psychiatry, 1994
A prospective study was undertaken of physical assaults over six months in a newly opened psychiatric intensive care unit. There were 58 admissions of 48 patients, and 37 assaults, three against other patients, and 34 against nursing and medical staff. Features which correlated with committing assault were a criminal record and previous drug abuse. Assaults occurred most frequently during the week, at times when staff were actively involved with the patients.