scholarly journals Aggressive behaviour in an acute general adult psychiatric unit

2006 ◽  
Vol 30 (5) ◽  
pp. 166-168 ◽  
Author(s):  
Selim M. El-Badri ◽  
Graham Mellsop
Keyword(s):  
Risk Assessment ◽  
Hospital Stay ◽  
Aggressive Behaviour ◽  
Substance Misuse ◽  
Overt Aggression ◽  
Psychiatric Ward ◽  
Clinical Implications ◽  
History Of ◽  
Acute Psychiatric Ward ◽  
Overt Aggression Scale

Aims and MethodThe study aimed to identify the correlates of aggressive behaviour in an adult acute psychiatric ward. Over a period of 9 months, all incidents of verbal and physical aggressive behaviour exhibited by in-patients were routinely assessed using the Overt Aggression Scale.ResultsOf the 535 patients admitted during the study period, 80 (15%) were involved in a total of 124 aggressive incidents. Of these 80, 44 (55%) had a history of previous violence and 54 (68%) had a history of substance misuse. The majority of events occurred early in the hospital stay and in most cases aggression was against staff. There were significant differences between aggressive and non-aggressive patients in terms of gender and ethnicity, with the lowest rate occurring in European females.Clinical ImplicationsThese results reinforce clinical impressions, and empirical evidence, and allow risk assessment to be performed with greater confidence. The relevance of ethnicity (or more likely culture) highlights the difficulties of a ‘one size fits all’ approach to risk assessment.

scholarly journals Violent behaviour in schizophrenia

2005 ◽  
Vol 187 (5) ◽  
pp. 426-430 ◽  
Author(s):  
Jan Vevera ◽  
Alan Hubbard ◽  
Arnošt Veselý ◽  
Hana Papežová
Keyword(s):  
Logistic Regression ◽  
Substance Misuse ◽  
Overt Aggression ◽  
Psychotic Symptoms ◽  
Violent Behaviour ◽  
Stable Conditions ◽  
Dsm Iv ◽  
Available Information ◽  
Overt Aggression Scale ◽  
Over Time

BackgroundA number of studies have reported increased violence in patients with schizophrenia.AimsTo determine the prevalence of violence among those with schizophrenia in samples from 1949, 1969, 1989 and 2000 in Prague (Czech Republic) and to examine trends in this behaviour.MethodRecords from 404 patients meeting DSM–IV criteria for schizophrenia were screened for violence (defined as 3 points on the Modified Overt Aggression Scale) from the first observed psychotic symptoms until the time of latest available information.ResultsLogistic regression revealed a marginally significant increase in violence only inthe 2000 cohort. Overall, violence was associated with schizophrenia in 41.8% of men and 32.7% of women, with no association between substance misuse and violence.ConclusionsThe violence rate found in our sample is expected to remain stable over time under stable conditions. Substance misuse is not the leading cause of violence among those with schizophrenia.

scholarly journals Changes in diagnoses before admission to a specialist medium secure unit

2012 ◽  
Vol 36 (11) ◽  
pp. 404-408 ◽  
Author(s):  
Amrith Shetty ◽  
Dilum Jayawickrama ◽  
Pamela J. Taylor
Keyword(s):  
Substance Misuse ◽  
Service Providers ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Psychotic Illness ◽  
Violent Behaviour ◽  
Medium Security ◽  
History Of ◽  
Secure Unit ◽  
Study Participants

Aims and methodThere is evidence that changing diagnoses may be an important factor preceding homicide, but there is little literature on diagnostic antecedents to admission to specialist secure units after violent behaviour. Our aim was to establish the frequency of a history of changing diagnoses in patients in a UK specialist unit, and to explore the characteristics of these patients.ResultsIn total, 38 of 42 study participants had prior contact with psychiatric services. Just over 40% (16 of the 38) had had their diagnosis changed three or more times. All those who had major changes in their diagnosis had received a diagnosis of a psychotic illness at some point prior to the secure unit admission, but then had it withdrawn, only to be restored after prolonged assessment in the secure unit. Personality disorder and substance misuse comorbidity was common in this group; however, non-psychotic diagnoses were seen as more important than psychotic diagnoses by general services.Clinical implicationsChanges in diagnosis between first presentation to psychiatric services and admission to a medium-security unit were more common than would be expected from reports in the general literature. They are a testimony to the difficulties experienced by service providers in delivering a consistent service. This needs to be studied further.

scholarly journals Specialised in-patient psychiatric service for women

1999 ◽  
Vol 23 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Doro Kohen
Keyword(s):  
Inner City ◽  
Mental Health Professionals ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Psychiatric Ward ◽  
Clinical Implications ◽  
Admission Criteria ◽  
Single Gender ◽  
Staffing Levels ◽  
Acute Psychiatric Ward

Aims and methodTo describe one of the first psychiatric services in the inner-city especially designated for female psychiatric patients with severe mental illness.ResultsThe referral system, the staffing levels and the admission criteria have been established following needs of the patients, especially young women with perinatal problems and women from ethnic minorities.Clinical implicationsThis single gender acute psychiatric ward has received welcome attention from mental health professionals and management at every level, and it is hoped that further discussion will help to clarify future policies and guidelines on all aspects of this venture.

scholarly journals Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258346
Author(s):  
Irene Weltens ◽  
Maarten Bak ◽  
Simone Verhagen ◽  
Emma Vandenberk ◽  
Patrick Domen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aggressive Behaviour ◽  
Job Strain ◽  
Psychiatric Ward ◽  
Patient Factors ◽  
Targeted Interventions ◽  
Explanatory Factors ◽  
Burn Out ◽  
History Of ◽  
Restrictive Environment

Introduction On psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards. Method In Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included. Results The prevalence of aggressive behaviour on psychiatric wards varied (8–76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy. Conclusion Despite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.

scholarly journals Zuclopenthixol in adults with intellectual disabilities and aggressive behaviours

2007 ◽  
Vol 190 (5) ◽  
pp. 447-448 ◽  
Author(s):  
Frank Haessler ◽  
Thomas Glaser ◽  
Manfred Beneke ◽  
Akos F. Pap ◽  
Ralf Bodenschatz ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Aggressive Behaviour ◽  
Overt Aggression ◽  
Open Treatment ◽  
Aggressive Behaviours ◽  
Adults With Intellectual Disabilities ◽  
Overt Aggression Scale

SummaryWe investigated the effects of zuclopenthixol on aggressive behaviour in patients with intellectual disabilities by randomly withdrawing it after a 6-week period of open treatment. Of the 49 patients responding to the treatment, 39 took part in a randomised withdrawal trial. The placebo subgroup (n=20) showed more aggressive behaviour as indicated by outcomes observed by external raters on the Modified Overt Aggression Scale than did the continuing subgroup (n=19). The results indicate that discontinuation of zuclopenthixol in this population leads to an increase in aggressive behaviour.

Patients’ Self-Report as Predictor of Self-Harm and Violence in an Acute Psychiatric Unit. A Prospective Naturalistic Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J.O. Roaldset ◽  
S. Bjørkly ◽  
K.G. Gøtestam
Keyword(s):  
Hospital Stay ◽  
Psychiatric Patients ◽  
Phase 1 ◽  
Self Report ◽  
Psychiatric Ward ◽  
Phase 2 ◽  
Violent Behaviour ◽  
Self Mutilation ◽  
Self Harm ◽  
Acute Psychiatric Ward

The risk of self-harm and violent behaviour by psychiatric patients is an important clinical research topic. However, a literature search on measurement of patients’ structured self-reported assessment of future risk of violent, suicidal or self mutilating behaviour failed to disclose any published empirical research. In the acute psychiatric ward at Ålesund Hospital in Norway we conducted a study of risk assessment of self harm and violent behaviour at admittance and at discharge, followed by prospective measurement of occurred episodes.All admitted patients during one year (489 persons with 716 stays) were included. At admittance and at discharge the Violence Risk Screening-10 (V-RISK-10), items taping suicidal thoughts and behaviour, and patients’ structured self-reported risk of self-harm and violent behaviour (583 self-reports) were scored (six items: no risk-, little-, moderate-, high-, very high risk, don't know the risk, will not answer). The patients were asked to give a blood sample to measure lipids and serotonin. Incidents of aggressive behaviour (against others and self-directed) were monitored during hospital stay (phase 1) and 3, 6, 9 and 12 months after discharge (phase 2).Preliminary results pertaining to the relationship between the patients’ predictions of self-harm and violent behaviour and occurred episodes during the subsequent hospital stay (phase 1) and the first three months after discharge (phase 2), indicate that the predictive validity of patients’ self-report was highly significant both for violent behaviour, suicidal behaviour and self mutilation in phase 1 and phase 2. Effect sizes ranged from moderate to high.

scholarly journals Monitoring risk assessment on an acute psychiatric ward: Effects on aggression, seclusion and nurse behaviour

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0240163
Author(s):  
Esther J. R. Florisse ◽  
Philippe A. E. G. Delespaul
Keyword(s):  
Risk Assessment ◽  
Psychiatric Ward ◽  
Acute Psychiatric Ward

scholarly journals The outcome of rough sleepers with mental health problems admitted to a psychiatric ward

1999 ◽  
Vol 23 (3) ◽  
pp. 164-166 ◽  
Author(s):  
Zoë C. Graham ◽  
Frankie S. Salton-Cox ◽  
Peter D. White
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Psychiatric Ward ◽  
Clinical Implications ◽  
Involuntary Admission ◽  
Psychiatric Admission ◽  
Acute Psychiatric Ward

Aims and methodTo describe the outcome of rough sleepers admitted to an acute psychiatric ward; the professional most involved with the person was interviewed.ResultsEleven out of 12 people admitted with a psychosis were accommodated and in touch with mental health services at follow-up (median of 21 months) compared with two out of 10 people, admitted without a psychosis, accommodated and four out of 10 people in touch with mental health services.Clinical implicationsPsychiatric admission with good aftercare is worthwhile for rough sleepers with a psychosis, even if it requires involuntary admission.

scholarly journals Prescribing Patterns of Psychotropic Drugs and Risk of Violent Behavior: A Prospective, Multicenter Study in Italy

2020 ◽  
Vol 23 (5) ◽  
pp. 300-310
Author(s):  
E di Giacomo ◽  
A Stefana ◽  
V Candini ◽  
G Bianconi ◽  
L Canal ◽  
...  
Keyword(s):  
Aggressive Behavior ◽  
Psychotropic Drugs ◽  
Rating Scale ◽  
Violent Behavior ◽  
Prescribing Patterns ◽  
Overt Aggression ◽  
History Of ◽  
Axis I ◽  
Overt Aggression Scale

Abstract Background This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. Methods A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. Results The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = .001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. Conclusion Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior.

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