Characteristics of aggression in a German psychiatric hospital and predictors of patients at risk.
This study investigated the aggressive behaviour of all mentally ill patients within a whole psychiatric hospital with a catchment area of 325 000 inhabitants over a 1-year period (i) to assess the 1-year prevalence and characteristics of aggressive episodes and index inpatients, and (ii) to identify predictors of patients at risk by a multivariate approach. Staff Observation of Aggression Scale was used to assess aggressive behaviour. Characteristics of index inpatients were compared with those of non-index inpatients. Logistic regression analysis was applied to identify risk factors. A total of 171 out of 2210 admitted patients (7.7%) exhibited 441 aggressive incidents (1.7 incidents per bed per year). Logistic regression analyses revealed as major risk factors of aggression: diagnoses (organic brain syndromes OR = 3.6, schizophrenia OR = 2.9), poor psychosocial living conditions (OR = 2.2), and critical behaviour leading to involuntary admission (OR = 3.3). Predictors of aggressive behaviour can be useful to identify inpatients at risk. Nevertheless, additional situational determinants have to be recognized. Training for professionals should include preventive and de-escalating strategies to reduce the incidence of aggressive behaviour in psychiatric hospitals. The application of de-escalating interventions prior to admission might be effective in preventing aggressive behaviour during inpatient treatment especially for patients with severe mental disorders.
Ketelsen
R
R
Department of Psychiatry and Psychotherapy, Ev. Hospital Bielefeld, Bethel, Remterweg 69-71, D-33617 Bielefeld, Germany. regina.ketelsen@evkb.de
Zechert
C
C
Driessen
M
M
Schulz
M
M
D000328:Adult; D000374:Aggression / Q000523:psychology*; D003710:Demography; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D005791:Patient Care / Q000592:standards*; D011446:Prospective Studies; D012307:Risk Factors