title: Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence.
abstract: Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour.
  
  
  
  To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up.
  
  
  
  In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour.
  
  
  
  The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression.
  
  
  
  Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.
authors.affiliation: Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.affiliation: Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Buizza
authors.affiliation: Institute of Biomathematics, University of Urbino, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Sisti
authors.affiliation: Service of Statistics, Saint John of God Clinical Research Center, Brescia, Italy.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Ferrari
authors.affiliation: Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy; PhD School in Psychology, Catholic University of the Sacred Heart, Milan, Italy.
authors.forename: Viola
authors.initials: V
authors.lastname: Bulgari
authors.affiliation: Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Iozzino
authors.affiliation: Rehabilitation Hospital Beata Vergine Della Consolata, Torino, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Boero
authors.affiliation: Villa Sant'Ambrogio Hospital, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cristiano
authors.affiliation: Rehabilitation Hospital Beata Vergine Della Consolata, Torino, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: De Francesco
authors.affiliation: Villa Sant'Ambrogio Hospital, Milan, Italy; Sacro Cuore di Gesù Center, Milan, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Giobbio
authors.affiliation: Sacro Cuore di Gesù Center, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Maggi
authors.affiliation: Psychiatric Unit, Saint John of God Clinical Research Center, Brescia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Villa Sant'Ambrogio Hospital, Milan, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Segalini
authors.affiliation: Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy; Department of General Psychology, University of Padova, Italy. Electronic address: vcandini@fatebenefratelli.eu.
authors.forename: Valentina
authors.initials: V
authors.lastname: Candini
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000374:Aggression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014754:Violence / Q000523:psychology*; D055815:Young Adult
keywords: Mental disorders; Recidivism; Residential facilities; Violence