title: Short-term prediction of threatening and violent behaviour in an Acute Psychiatric Intensive Care Unit based on patient and environment characteristics.
abstract: BACKGROUND
  The aims of the present study were to investigate clinically relevant patient and environment-related predictive factors for threats and violent incidents the first three days in a PICU population based on evaluations done at admittance.
  
  
  METHODS
  In 2000 and 2001 all 118 consecutive patients were assessed at admittance to a Psychiatric Intensive Care Unit (PICU). Patient-related conditions as actuarial data from present admission, global clinical evaluations by physician at admittance and clinical nurses first day, a single rating with an observer rated scale scoring behaviours that predict short-term violence in psychiatric inpatients (The Brøset Violence Checklist (BVC)) at admittance, and environment-related conditions as use of segregation or not were related to the outcome measure Staff Observation Aggression Scale-Revised (SOAS-R). A multiple logistic regression analysis with SOAS-R as outcome variable was performed.
  
  
  RESULTS
  The global clinical evaluations and the BVC were effective and more suitable than actuarial data in predicting short-term aggression. The use of segregation reduced the number of SOAS-R incidents.
  
  
  CONCLUSIONS
  In a naturalistic group of patients in a PICU segregation of patients lowers the number of aggressive and threatening incidents. Prediction should be based on clinical global judgment, and instruments designed to predict short-term aggression in psychiatric inpatients.
  
  
  BACKGROUND
  NCT00184119/NCT00184132.
authors.affiliation: Department of Neuroscience, Norwegian, University of Science and Technology, Trondheim, Norway. arne.e.vaaler@ntnu.no
authors.forename: Arne E
authors.initials: AE
authors.lastname: Vaaler
authors.forename: Valentina C
authors.initials: VC
authors.lastname: Iversen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Morken
authors.forename: John C
authors.initials: JC
authors.lastname: Fløvig
authors.forename: Tom
authors.initials: T
authors.lastname: Palmstierna
authors.forename: Olav M
authors.initials: OM
authors.lastname: Linaker
mesh_terms: D000374:Aggression / Q000523:psychology*; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units; D001523:Mental Disorders / Q000523:psychology*; D012931:Social Environment; D014754:Violence / Q000523:psychology*