Characteristics of assaultive patients with schizophrenia versus personality disorder: six year analysis of the Assaulted Staff Action Program (ASAP).
Literature reviews of individual assaultive patients, repetitively violent patients, and restrained assaultive patients document that persons diagnosed with schizophrenia or personality disorder are at the highest risk to become assaultive. While there has been some initial research of possible predictor variables across diagnostic groups, this six-year retrospective study is the first to compare only persons with schizophrenia or personality disorder on basic demographic and the selected clinical variables of history of violence, personal victimization, and substance use disorder. In this study, the variance suggested that persons with schizophrenia and personality disorder were both likely to be assaultive. Assaults by persons with schizophrenia were somewhat proportional to their presence in the population studied. However, personality disordered patients represented a disproportional increase from the population studied. Younger females with a diagnosis of personality disorder and with histories of violence toward others and personal victimization appeared at increased risk to be assaultive and to require restraints. The findings and their implications for safety and clinical care are discussed.
Flannery
Raymond B
RB
The Massachusetts Department of Mental Health, Boston 02114, USA.
Rachlin
Stephen
S
Walker
Andrew P
AP
D000293:Adolescent; D000328:Adult; D000368:Aged; D019548:Crime Victims / Q000523:psychology; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000150:complications / Q000523:psychology*; D012189:Retrospective Studies; D012563:Schizophrenia, Paranoid / Q000150:complications / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology; D014754:Violence / Q000523:psychology*