title: Violence in psychiatric units: a 7-year Italian study of persistently assaultive patients.
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.
authors.affiliation: Section of Psychiatry, Department of Medical Sciences of Communication and Behaviour, University of Ferrara, Ferrara, Italy. luigi.grassi@unife.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Grassi
authors.forename: Bruno
authors.initials: B
authors.lastname: Biancosino
authors.forename: Luciana
authors.initials: L
authors.lastname: Marmai
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Kotrotsiou
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Zanchi
authors.forename: Luana
authors.initials: L
authors.lastname: Peron
authors.forename: Claudio
authors.initials: C
authors.lastname: Marangoni
authors.forename: Adello
authors.initials: A
authors.lastname: Vanni
authors.forename: Corrado
authors.initials: C
authors.lastname: Barbui
mesh_terms: D000328:Adult; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D015995:Prevalence; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*