Short-term prediction of threatening and violent behaviour in an Acute Psychiatric Intensive Care Unit based on patient and environment characteristics

<p>Abstract</p> <p>Background</p> <p>The aims of the present study were to investigate clinically relevant patient and environment-related predictive factors for threats and violent incidents the first three days in a PICU population based on evaluations done at admittance.</p> <p>Methods</p> <p>In 2000 and 2001 all 118 consecutive patients were assessed at admittance to a Psychiatric Intensive Care Unit (PICU). Patient-related conditions as actuarial data from present admission, global clinical evaluations by physician at admittance and clinical nurses first day, a single rating with an observer rated scale scoring behaviours that predict short-term violence in psychiatric inpatients (The Brøset Violence Checklist (BVC)) at admittance, and environment-related conditions as use of segregation or not were related to the outcome measure Staff Observation Aggression Scale-Revised (SOAS-R). A multiple logistic regression analysis with SOAS-R as outcome variable was performed.</p> <p>Results</p> <p>The global clinical evaluations and the BVC were effective and more suitable than actuarial data in predicting short-term aggression. The use of segregation reduced the number of SOAS-R incidents.</p> <p>Conclusions</p> <p>In a naturalistic group of patients in a PICU segregation of patients lowers the number of aggressive and threatening incidents. Prediction should be based on clinical global judgment, and instruments designed to predict short-term aggression in psychiatric inpatients.</p> <p>Trial registrations</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT00184119">NCT00184119</a>/<a href="http://www.clinicaltrials.gov/ct2/show/NCT00184132">NCT00184132</a></p

Predicting inpatient violence using an extended version of the Brøset-Violence-Checklist: instrument development and clinical application

BACKGROUND: Patient aggression is a common problem in acute psychiatric wards and calls for preventive measures. The timely use of preventive measures presupposes a preceded risk assessment. The Norwegian Brøset-Violence-Checklist (BVC) is one of the few instruments suited for short-time prediction of violence of psychiatric inpatients in routine care. Aims of our study were to improve the accuracy of the short-term prediction of violence in acute inpatient settings by combining the Brøset-Violence-Checklist (BVC) with an overall subjective clinical risk-assessment and to test the application of the combined measure in daily practice. METHOD: We conducted a prospective cohort study with two samples of newly admitted psychiatric patients for instrument development (219 patients) and clinical application (300 patients). Risk of physical attacks was assessed by combining the 6-item BVC and a 6-point score derived from a Visual Analog Scale. Incidents were registered with the Staff Observation of Aggression Scale-Revised SOAS-R. Test accuracy was described as the area under the receiver operating characteristic curve (AUC(ROC)). RESULTS: The AUC(ROC )of the new VAS-complemented BVC-version (BVC-VAS) was 0.95 in and 0.89 in the derivation and validation study respectively. CONCLUSION: The BVC-VAS is an easy to use and accurate instrument for systematic short-term prediction of violent attacks in acute psychiatric wards. The inclusion of the VAS-derived data did not change the accuracy of the original BVC

Proceedings of the 5th European Congress on Violence in Clinical Psychiatry

Item does not contain fulltext383 p

Fifteen years of research with the Staff Observation Aggression Scale; A review

Contains fulltext : 56855.pdf (publisher's version ) (Closed access

Violence in Clinical Psychiatry. Proceedings of the 6th European congress

Item does not contain fulltextThis book of conference proceedings offers an overview of the work of many clinicians, researchers, and others on topics pertinent to the field of clinical violence such as legal and ethical perspectives on violence, the impact of violence on patients and staff, coercive measures, the pharmacological treatment of violence, the biology of violence, and interventions to address the problem of violence in clinical psychiatry. The congress offers a platform to all persons interested in the subject and to encourage the congress participants to engage in discussion and exchange on the various facets of violence. Readers of the conference proceedings will benefit from the topical findings presented here and will receive a wealth of stimulating ideas to enrich their own clinical practice.384 p

Violence in clinical psychiatry: Proceedings of the 10th European Congress on Violence in Clinical Psychiatry

Item does not contain fulltextProceedings of the 10th European Congress on Violence in Clinical Psychiatry. The 10th European Congress on Violence in Clinical Psychiatry is co-organized by the European Violence in Psychiatry Research Group (EViPRG) & the European Network for Training in the Management of Aggression (ENTMA08), and is a World Psychiatric Association (WPA) co-sponsored meeting. The 10th European Congress on Violence did focus strongly on clinically relevant and practically useful interdisciplinary scientific and practical knowledge with regard to interventions aimed at treating and reducing violence and aggression. The overall congress theme: "Creating collaborative care: a multi-partnership approach" reflects our commitment to partnership working between clinicians, researchers, educators, service users and carers.10th European Congress on Violence in Clinical Psychiatry: Creating collaborative care: A multi-partnership approach (Dublin, Ireland, 26 - 28 October 2017)448 p

Proceedings of the 9th European Congress on Violence in Clinical Psychiatry

Item does not contain fulltext448 p