Violence committed by acute psychiatric inpatients represents an important and challenging problem in clinical practice. The aim of this study is to evaluate the prevalence and characteristics of violent and hostile behavior and to identify predictors of aggression in a representative sample of patients admitted to Italian public and private acute psychiatric inpatient facilities during an index period in the year 2004. Socio-demographic, clinical, and treatment information were collected for 1,324 patients (677 men and 647 women) discharged from a representative sample of public and private Italian acute psychiatric facilities during an index period in 2004. The sample was divided into three groups: non-hostile patients (no episodes of violent behavior during hospitalisation), hostile patients (verbal aggression or violent acts against property), and violent patients (authors of physical assault). Ten percent (N=129) of patients showed hostile behavior during hospitalisation and 3% (N=37) physically assaulted other patients or staff members. Schizophrenia and related disorders were the most frequent diagnoses (35,9%) among aggressive patients. Variables associated with violent behavior were: male gender, <24 years of age, unmarried status, receiving a disability pension, having a secondary school degree, compulsory admission, hostile attitude at admission, and a diagnosis of schizophrenia, bipolar disorder, personality disorders, mental retardation, organic brain disorder or substance/alcohol abuse. Hostile and violent patients showed a higher probability of discharge to ‘restrictive’ settings rather than to home. Violent behavior during hospitalisation was a predictive factor for higher BPRS scores and for lower PSP scores at discharge. Despite the low percentage of violent and hostile behavior observed in Italian acute inpatient units, this study shed light on a need for the careful assessment of clinical and treatment variables and greater effort aimed at improving specific prevention and treatment programmes of violent behavior.

Violent Behaviour in Acute Psychiatric Inpatient Facilities - A National Survey in Italy

BIANCOSINO, Bruno;GRASSI, Luigi;
2009

Abstract

Violence committed by acute psychiatric inpatients represents an important and challenging problem in clinical practice. The aim of this study is to evaluate the prevalence and characteristics of violent and hostile behavior and to identify predictors of aggression in a representative sample of patients admitted to Italian public and private acute psychiatric inpatient facilities during an index period in the year 2004. Socio-demographic, clinical, and treatment information were collected for 1,324 patients (677 men and 647 women) discharged from a representative sample of public and private Italian acute psychiatric facilities during an index period in 2004. The sample was divided into three groups: non-hostile patients (no episodes of violent behavior during hospitalisation), hostile patients (verbal aggression or violent acts against property), and violent patients (authors of physical assault). Ten percent (N=129) of patients showed hostile behavior during hospitalisation and 3% (N=37) physically assaulted other patients or staff members. Schizophrenia and related disorders were the most frequent diagnoses (35,9%) among aggressive patients. Variables associated with violent behavior were: male gender, <24 years of age, unmarried status, receiving a disability pension, having a secondary school degree, compulsory admission, hostile attitude at admission, and a diagnosis of schizophrenia, bipolar disorder, personality disorders, mental retardation, organic brain disorder or substance/alcohol abuse. Hostile and violent patients showed a higher probability of discharge to ‘restrictive’ settings rather than to home. Violent behavior during hospitalisation was a predictive factor for higher BPRS scores and for lower PSP scores at discharge. Despite the low percentage of violent and hostile behavior observed in Italian acute inpatient units, this study shed light on a need for the careful assessment of clinical and treatment variables and greater effort aimed at improving specific prevention and treatment programmes of violent behavior.
Biancosino, Bruno; Delmonte, S.; Grassi, Luigi; Santone, G.; Preti, A.; Miglio, R.; DE GIROLAMO G., for the PROGRES Acute Group
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11392/532095
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