Psychiatric diagnosis and aggression before acute hospitalisation.
OBJECTIVE
To examine the predictors of aggressive behaviours occurring before acute hospitalisation.


METHODS
We analysed 350 acute admissions to a psychiatric ward during a 12-month period. The diagnoses were formulated according to the DSM IV axis I and II criteria. Aggressive behaviours occurring in the week before admission were retrospectively assessed using the modified overt aggression scale. The patients' clinical and sociodemographic variables, concurrent drug or alcohol abuse, and admission status were recorded at the time of admission.


RESULTS
Aggressive and violent behaviours were highly prevalent, respectively, in 45% and 33% of the cases. Violence before admission was independently associated with drug abuse, involuntary admission status, and severe psychopathology. A diagnosis of a psychotic disorder did not increase the risk of aggression or violence, compared to the other psychiatric diagnoses. Personality disorders were significantly more associated to aggressive behaviours than psychotic disorders.


CONCLUSIONS
The diagnosis of psychotic disorder is a poor predictor of aggression in a sample of psychiatric patients. Other clinical and non-clinical variables are associated to aggression before hospitalisation: they include drug abuse, involuntary admission status, general severity of symptoms, and diagnosis of personality disorder.
Colasanti
A
A
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122 Milan, Italy.
Natoli
A
A
Moliterno
D
D
Rossattini
M
M
De Gaspari
I F
IF
Mauri
M C
MC
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010054:Brief Psychiatric Rating Scale; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult