Skip to main content
×
×
Home

Aggressive incidents on a psychiatric intensive care unit

  • Dermot P. Cohen (a1), Mohammed Saleem Akhtar (a1), Adeel Siddiqui (a1), Cathy Shelley (a1), Conal Larkin (a1), Anthony Kinsella (a1), Eadbhard O'Callaghan (a2) and Abbie Lane (a3)...
Abstract
Aims and Method

This study looked at patient aggressive behaviour on an Irish psychiatric intensive care unit, and whether it was related to diagnosis, patient's insight and symptomatology. Each aggressive incident was recorded throughout the patient's stay using the Staff-Observed Aggression Scale.

Results

Ninety-nine individuals were admitted to the unit during the study. We recorded 82 aggressive incidents, with most occurring during the daytime and on weekdays. There was no statistical difference in BPRS scores between the aggressive and non-aggressive groups. the aggressive patient group had a lower insight score than the non-aggressive group (P < 0.05) as measured on the Schedule of the Assessment of Insight. However, when gender and verbal aggression only were included in the analysis, the difference in insight was less significant (P=0.07).

Clinical Implications

Aggression is common on a psychiatric intensive care unit. Low levels of insight in patients may increase the risk of aggression.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Aggressive incidents on a psychiatric intensive care unit
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Aggressive incidents on a psychiatric intensive care unit
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Aggressive incidents on a psychiatric intensive care unit
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
Hide All
Buckley, P. F., Hrouda, D. R., Friedman, L., et al (2004) Insight and its relationship to violent behaviour in patients with schizophrenia. American Journal of Psychiatry, 161, 17121724.
Chou, K. R., Lu, R. B. & Mao, W. C. (2002) Factors relevant to patient assaultive behavior and assault in acute in-patient psychiatric units in Taiwan. Archives of Psychiatric Nursing, 16, 187195.
David, A.S. (1990) Insight and psychosis. British Journal of Psychiatry, 156, 798808.
Department of Health (2002) National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units (PICS) and Low Secure Environments. Department of Health Publications.
El-Badri, S. M. & Mellsop, G. (2006) Aggressive behaviour in an acute general adult psychiatric unit. Psychiatric Bulletin, 30, 166168.
Ferns, T. (2006) Under-reporting of violent incidents against nursing staff. Nursing Standards, 40, 4145.
Foley, S. R., Kelly, B. D., Clarke, M., et al (2005) Incidence and clinical correlates of aggression and violence at presentation in patients with first episode psychosis. Schizophrenia Research, 72, 161168.
Grassi, L., Peron, L., Marangoni, C., et al (2001) Characteristics of violent behaviour in acute psychiatric in-patients: a 5-year Italian study. Acta Psychiatrica Scandinavica, 104, 273279.
James, D.V., Fineberg, N. A., Shah, A. K., et al (1990) An increase in violence on an acute psychiatric ward. A study of associated factors. British Journal of Psychiatry, 156, 846852.
Nijman, H. L., Allertz, W. W. F., Merckelbach, H. L. G. J., et al (1997) Aggressive behaviour on an acute psychiatric admissions ward. European Journal of Psychiatry, 11, 106114.
Nijman, H. L., Muris, P., Merckelbach, H. L. G. J., et al (1999) The Staff Observation Aggression Scale – Revised (SOAS–R). Aggressive Behaviour, 25, 197209.
Nijman, H. L., Palmstierna, T., Almvik, R., et al (2005) Fifteen years of research with the Staff Observation Aggression Scale: a review. Acta Psychiatrica Scandinavica, 111, 1221.
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale (BPRS). Psychological Reports, 10, 799812.
Rossi, A. M., Jacobs, M., Monteleone, M., et al (1985) Violent or fear-inducing behaviour associated with hospital admission. Hospital and Community Psychiatry, 36, 643647.
Saverimuttu, A. & Lowe, T. (2000) Aggressive incidents on a psychiatric intensive care unit. Nursing Standards, 35, 3336.
Shah, A. K., Fineberg, N. A. & James, D.V. (1991) Violence among psychiatric in-patients. Acta Psychiatrica Scandinavica, 184, 305309.
Steinert, T., Wiebe, C. & Gebhardt, R. P. (1999) Aggressive behaviour against self and others among first-admission patients with schizophrenia. Psychiatry Services, 50, 8590.
Swanson, J.W., Holzer, C. E., Ganju, V. K., et al (1990) Violence and psychiatric disorder in the community: evidence from the epidemiologic catchment area surveys. Hospital & Community Psychiatry, 41, 761770.
Tardiff, K., Marzuk, P. M., Leon, A. C., et al (1997) A prospective study of violence by psychiatric patients after hospital discharge. Psychiatry Services, 48, 678681.
Walsh, E., Gilvarry, C., Samele, C., et al (2004) UK700 Group. Predicting violence in schizophrenia: a prospective study. Schizophrenia Research, 67, 247252.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 11 *
Loading metrics...

Abstract views

Total abstract views: 58 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 19th July 2018. This data will be updated every 24 hours.

Aggressive incidents on a psychiatric intensive care unit

  • Dermot P. Cohen (a1), Mohammed Saleem Akhtar (a1), Adeel Siddiqui (a1), Cathy Shelley (a1), Conal Larkin (a1), Anthony Kinsella (a1), Eadbhard O'Callaghan (a2) and Abbie Lane (a3)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *