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Violence in psychiatric units

A 7-year Italian study of persistently assaultive patients

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Abstract

Background

The problem of violence and aggressive behaviour among patients with psychiatric disorders need careful assessment to improve the quality of psychiatric care. The aim of this paper is to describe the characteristics of repeated episodes of violence among patients admitted to an Italian psychiatric ward.

Methods

All violent behaviours, which occurred in a 15-bed psychiatric inpatient unit over a 7-year period, were assessed by using the Staff Observation Aggression scale (SOAS).

Results

Of a total of 3.507 admissions, 409 aggressive episodes were recorded by 160 patients (rate per admission 11.6%). A total of 65 patients exhibited two or more episodes and 95 patients showed a single episode. Repeatedly violent patients had a higher length of stay in the unit, a higher number of previous admissions and a higher number of previous violent episodes. No difference was found in terms of psychiatric diagnosis, socio-demographic variables, type of admission (voluntary versus involuntary), ward overcrowding and characteristics of violent episodes (means, aims and consequence).

Conclusions

In spite of the low prevalence of violent incidents among Italian psychiatric inpatients, careful monitoring of clinical variables associated with repeated violent episodes may help physicians recognise and prevent violence episodes among acute psychiatric inpatients.

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Acknowledgements

The Authors are indebted to the staff for their cooperation in the study and to Paul Packer, PhD, for his professional help in revising the manuscript.

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Authors and Affiliations

  1. Section of Psychiatry, Department of Medical Sciences of Communication and Behaviour, University of Ferrara, Ferrara, Italy

    Luigi Grassi MD, Bruno Biancosino, Luciana Marmai, Vasiliki Kotrotsiou & Pierluigi Zanchi

  2. Inpatient Rehabilitation Unit, Dept. of Mental Health, Local Health Organization, Ferrara, Italy

    Luigi Grassi MD, Bruno Biancosino & Luciana Marmai

  3. Clinica Psichiatrica , Università di Ferrara, Corso Giovecca 203, 44100, Ferrara, Italy

    Luigi Grassi MD

  4. Inpatient Psychiatric Unit, Department of Mental Health, Local Health Organization, Ferrara, Italy

    Luana Peron, Claudio Marangoni & Adello Vanni

  5. Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy

    Corrado Barbui

Authors
  1. Luigi Grassi MD
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  2. Bruno Biancosino
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  3. Luciana Marmai
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  4. Vasiliki Kotrotsiou
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  5. Pierluigi Zanchi
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  6. Luana Peron
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  7. Claudio Marangoni
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  8. Adello Vanni
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  9. Corrado Barbui
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Corresponding author

Correspondence to Luigi Grassi MD.

Additional information

The authors report no financial affiliation and other relationship relevant to the subject matter of this study.

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Grassi, L., Biancosino, B., Marmai, L. et al. Violence in psychiatric units. Soc Psychiat Epidemiol 41, 698–703 (2006). https://doi.org/10.1007/s00127-006-0088-5

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  • DOI: https://doi.org/10.1007/s00127-006-0088-5

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