Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-23T09:04:27.567Z Has data issue: false hasContentIssue false
  • English
  • Français

Prospective study into factors associated with aggressive incidents in psychiatric acute admission wards

Published online by Cambridge University Press:  03 January 2018

King Kho ,
Tom Sensky ,
Ann Mortimer  and
Christopher Corcos
King Kho
Affiliation:
Hounslow and Spelthorne Community and Mental Health NHS Trust, West Middlesex University Hospital
Tom Sensky*
Affiliation:
Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine, West Middlesex University Hospital
Ann Mortimer
Affiliation:
Department of Psychiatry, University of Hull, College of Health, De la Pole Hospital, Willerby, East Yorkshire
Christopher Corcos
Affiliation:
Hounslow and Spelthorne Community and Mental Health NHS Trust, West Middlesex University Hospital
*
Dr Tom Sensky, Lakeside Mental Health Unit, West Middlesex University Hospital, Isleworth, Middlesex TW7 6AF. Fax: 0181 244 9917; e-mail t.sensky@cxwms.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Factors associated with aggression among psychiatric in-patients are still poorly understood. Inconsistent published findings are partly attributable to methodological problems. Much previous research has been undertaken in specialist settings, where conditions are likely to differ from those in acute admission wards.

Method

Levels of aggression were ascertained weekly by staff report, using a reliable measure, for every patient on five acute admission wards and one locked intensive care ward at two hospitals prospectively over a five-month period.

Results

Levels of aggression varied considerably among the admission wards. Aggression was more common on the locked ward and among younger patients. Factors associated with aggression changed with time since admission (seldom examined in previous studies). Complex associations were found with gender, ethnic group and diagnosis.

Conclusions

Some of the findings might be explicable by differences in ward environment, and staff–patient interactions. Further investigation into these is warranted.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 1 , January 1998 , pp. 38 - 43
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Apperson, L. J., Mulvey, E. P. & Lidz, C. W. (1993) Short-term prediction of assaultive behaviour: artifacts of research methods. American Journal of Psychiatry, 150, 1374–1379.Google ScholarPubMed
Altman, D. (1991) Practical Statistics for Medical Research. London: Chapman and Hall.Google Scholar
Bartko, J. J. & Carpenter, W. T. (1976) On the methods and theory of reliability. Journal of Nervous and Mental Disease, 163, 307–317.CrossRefGoogle ScholarPubMed
Binder, R. L. & McNiel, D. E. (1990) The relationship of gender to violent behavior in acutely disturbed psychiatric patients. Journal of Clinical Psychiatry, 51, 110–114.Google ScholarPubMed
Ennis, B. & Emery, R. (1978) The Rights of Mental Patients. New York: Avon.Google Scholar
Fottrell, E. (1980) A study of violent behaviour among patients in psychiatric hospitals. British Journal of Psychiatry, 136, 216–221.CrossRefGoogle ScholarPubMed
Haller, R. M. & Deluty, R. H. (1988) Assaults on staff by psychiatric in-patients. British Journal of Psychiatry, 152, 174–179.CrossRefGoogle ScholarPubMed
James, D. V., Fineberg, N. A., Shah, A. K., et al (1990) An increase in violence on an acute psychiatric ward. British Journal of Psychiatry, 156, 846–852.CrossRefGoogle Scholar
Janofsky, J. S., Spears, S. & Neubauer, D. N. (1988) Psychiatrists' accuracy in predicting violent behaviour on an inpatient unit. Hospital and Community Psychiatry, 39, 1090–1094.Google Scholar
Katz, P. & Kirkland, F. R. (1990) Violence and social structure on mental hospital wards. Psychiatry, 53, 262–277.CrossRefGoogle ScholarPubMed
Lim, L., Tobin, M. & Falkowski, W. (1991) The characteristics of patients who display violent behaviour in a psychiatric hospital. British Journal of Clinical and Social Psychiatry, 8, 12–18.Google Scholar
Lion, J. R., Snyder, W. & Merrill, G. (1981) Underreporting of assaults on staff in a state hospital. Hospital and Community Psychiatry, 32, 497–499.Google ScholarPubMed
McCullagh, P. & Nelder, J. A. (1989) Generalised Linear Models. London: Chapman and Hall.CrossRefGoogle Scholar
McNiel, D. E. & Binder, R. L. (1991) Clinical assessment of the risk of violence among psychiatric inpatients. American Journal of Psychiatry, 148, 1317–1321.Google ScholarPubMed
Monahan, J. (1976) The prevention of violence. In Community Mental Health and the Criminal Justice System (ed. Monahan, J.). New York: Pergamon Press.Google Scholar
Noble, P. & Rodger, S. (1989) Violence by psychiatric in-patients. British Journal of Psychiatry, 155, 384–390.CrossRefGoogle ScholarPubMed
Pearson, M., Wilmot, E. & Padi, M. (1986) A study of violent behaviour among in-patients in a psychiatric hospital. British Journal of Psychiatry, 149, 232–235.CrossRefGoogle ScholarPubMed
Rossi, A. M., Jacobs, M., Monteleone, M., et al (1986) Characteristics of psychiatric patients who engage in assaultive or other fear-inducing behaviors. Journal of Nervous and Mental Disease, 174, 154–160.CrossRefGoogle ScholarPubMed
Smith, R. S. (1988) Comments on the overt aggression scale. American Journal of Psychiatry, 145, 1610.Google ScholarPubMed
Sorgi, P., Ratey, J., Knoedler, D. W., et al (1991) Rating aggression in the clinical setting, a retrospective adaptation of the overt aggression scale: preliminary results. Journal of Neuropsychiatry, 3, 52–56.Google ScholarPubMed
Tanke, E. D. & Yesavage, J. A. (1985) Characteristics of assaultive patients who do and do not provide visible cues of potential violence. American Journal of Psychiatry, 142, 1409–1413.Google Scholar
Yudofsky, S. C., Silver, J. M., Jackson, W., et al (1986) The overt aggression scale for the objective rating of verbal and physical aggression. American Journal of Psychiatry, 143, 35–39.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.