title: Aggression of psychiatric patients associated with the use of as-needed medication.
abstract: BACKGROUND
  Previous studies showed that aggression is an important reason to prescribe as-needed medication. The objective of this study was to compare the use of as-needed medication in aggressive and non-aggressive psychiatric patients and to explore patterns of administration of as-needed medication around aggressive incidents.
  
  
  METHODS
  An observational study in three psychiatric wards was conducted. Incidence densities of as-needed medication were determined for aggressive and non-aggressive patients and expressed as incidence density ratios [IDRs]. Intensity of as-needed medication used before and following aggressive incidents were determined within a 48-hours time-window.
  
  
  RESULTS
  Aggressive patients had an increased use of both psychotropic and somatic as-needed medication (IDR, 2.5; 95% CI, 2.2-2.7 and IDR, 2.1; 95% CI, 1.8-2.4, respectively). Of the psychotropic medication for aggressive patients, 15% was administered in a time-window of 48 hours around an aggressive incident; in this time-window more as-needed medication was administered following an aggressive incident compared to earlier treatments.
  
  
  CONCLUSIONS
  An increased use of both psychotropic and somatic as-needed medication is associated with aggressive behavior. Psychotropic as-needed medication is more frequently administered shortly after an aggressive incident than shortly before. However, more often as-needed medication is administered outside the 48 hours time-window around an aggressive incident.
authors.affiliation: Altrecht Institute for Mental Health Care, Den Dolder, The Netherlands.
authors.forename: L E
authors.initials: LE
authors.lastname: Goedhard
authors.forename: J J
authors.initials: JJ
authors.lastname: Stolker
authors.forename: H L I
authors.initials: HL
authors.lastname: Nijman
authors.forename: A C G
authors.initials: AC
authors.lastname: Egberts
authors.forename: E R
authors.initials: ER
authors.lastname: Heerdink
mesh_terms: D000328:Adult; D000374:Aggression / Q000187:drug effects / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs