Hostname: page-component-89b8bd64d-j4x9h Total loading time: 0 Render date: 2026-05-13T09:52:01.987Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric diagnosis and aggression before acute hospitalisation

Published online by Cambridge University Press:  16 April 2020

A. Colasanti ,
A. Natoli ,
D. Moliterno ,
M. Rossattini ,
I.F. De Gaspari  and
M.C. Mauri
A. Colasanti
Affiliation:
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milan, Italy
A. Natoli
Affiliation:
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milan, Italy
D. Moliterno
Affiliation:
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milan, Italy
M. Rossattini
Affiliation:
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milan, Italy
I.F. De Gaspari
Affiliation:
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milan, Italy
M.C. Mauri*
Affiliation:
Clinical Psychiatry, Guardia II, University of Milan, Clinical Neuropsychopharmacology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via F. Sforza 35, 20122Milan, Italy
*
*Corresponding author. Tel.: +39 02 55035997; fax: +39 02 55035990.E-mail address: e_sandre@hotmail.commaurimc@policlinico.mi.it(M.C. Mauri).
Get access

Abstract

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.

Conclusion

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.

Keywords

ViolenceSchizophrenia and psychosisPsychometry and assessments in psychiatryPsychiatry in EuropeAddiction (consumption/abuse/dependence)

Information

Type
Original article
Information
European Psychiatry , Volume 23 , Issue 6 , September 2008 , pp. 441 - 448
Copyright
Copyright © Elsevier Masson SAS 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association, Diagnostic and statistical manual of mental disorders (DSM)-IV-TR 4th ed. 1994 APA WashingtonGoogle Scholar
Appelbaum, P.S.Robbins, P.C.Monahan, J.Violence and delusions: data from the MacArthur violence risk assessment study Am J Psychiatry. 157 2000 566–572CrossRefGoogle ScholarPubMed
Arsenault, L.Moffitt, T.E.Caspi, A.Taylor, P.J.Silva, P.A.Mental disorders and violence in a total birth cohort: results of the Dunein study Arch Gen Psychiatry. 57 2000 979–986CrossRefGoogle Scholar
Ash, D.H.Galletly, C.Haynes, J.Braben, P.Violence self-harm, victimisation and homelessness in patients admitted to an acute inpatients unit in South Australia Int J Soc Psychiatry. 48 2003 45–47Google Scholar
Ballerini, A.Boccalon, R.Boncompagni, G.Casacchia, M.Margari, F.Minervini, L.et al.An observational study in psychiatric acute patients admitted to general hospital psychiatric wards in Italy Ann Gen Psychiatry. 6 2007 2CrossRefGoogle ScholarPubMed
Barlow, K.Grenyer, B.Ilkiw-Lavalle, O.Prevalence and precipitants of aggression in psychiatric inpatients units Aust N Z J Psychiatry. 34 2000 967–974CrossRefGoogle Scholar
Barman, E.Fallon, A.E.Coccaro, E.F.The relationship between personality psychopathology and aggressive behavior in research volunteers J Abnorm Psychol. 107 4 1998 651–658CrossRefGoogle Scholar
Boles, M.Miotto, K.Substance abuse and violence: a review of the literature Aggress Behav. 8 155 2003 174Google Scholar
Coccaro, E.F. Intermittent explosive disorder Coccaro, E.F.Aggression—psychiatric assessment and treatment. 2003 Marcel Dekker New York149–166CrossRefGoogle Scholar
Dazzan, P.Bhugra, D.Carta, M.G.Carpiniello, B.Decision making process for compulsory admission: study of a group of psychiatrists of Sardinia, Italy Epidemiol Psichiatr Soc. 10 2000 134Google Scholar
Eaton, W.Kessler, L.Epidemiological field methods in psychiatry: the NIMH epidemiologic catchment area study 1985 Academic Press New YorkGoogle Scholar
Foley, S.R.Kelly, B.D.Clarke, M.McTigue, O.Gervin, M.Kamali, M.et al.Incidence and clinical correlates of aggression and violence at presentation in patients with first episode psychosis Schizoph Res. 72 2005 161–168CrossRefGoogle ScholarPubMed
Gillies, D.O'Brien, L.Interpersonal violence and mental illness: a literature review Contemp Nurse. 21 2006 277–286CrossRefGoogle ScholarPubMed
Grassi, L.Biancospino, B.Marmai, L.Violence in psychiatric units: a 7-year Italian study of persistently assaultive patients Soc Psychiatry Epidemiol. 41 2006 698–703CrossRefGoogle ScholarPubMed
Grassi, L.Peron, L.Marangoni, C.Zanchi, P.Vanni, A.Characteristics of violent behaviour in acute psychiatric inpatients: a 5-years Italian study Acta Psychiatr Scand. 104 2001 273–279CrossRefGoogle Scholar
Grube, M.Gender differences in aggressive behavior at admission to a psychiatric hospital Aggress Behav. 33 2007 97–103CrossRefGoogle ScholarPubMed
Hodgins, S.Mental disorder, intellectual deficiency and crime: evidence from a birth cohort Arch Gen Psychiatry. 49 1992 476–483CrossRefGoogle ScholarPubMed
Humphrey, M.S.Johnstone, E.C.Macmillan, J.F.Taylor, P.J.Dangerous behaviour preceding first admissions for schizophrenia Br J Psychiatry. 161 1992 501–505CrossRefGoogle Scholar
Johnson, J.G.Cohen, P.Smailes, E.Kasen, S.Oldham, J.M.Skodol, A.E.et al.Adolescent personality disorders associated with violence and criminal behavior during adolescence and early adulthood Am J Psychiatry. 57 2000 1406–1412CrossRefGoogle Scholar
Kay, S.R.Wolkenfeld, F.Murrill, L.M.Profiles of aggression among psychiatric patients. I. Nature and prevalence J Nerv Ment Dis. 176 1988 539–546CrossRefGoogle ScholarPubMed
Krakowski, M.Czobor, P.Gender differences in violent behaviours: relationship to clinical symptoms and psychosocial factors Am J Psychiatry. 161 2004 459–465CrossRefGoogle ScholarPubMed
Modestin, J.Ammann, R.Mental disorders and criminal behaviour Br J Psychiatry. 166 1995 667–675CrossRefGoogle ScholarPubMed
Modestin, J.Ammann, R.Mental disorders and criminality: male schizophrenia Schizophr Bull. 22 1996 69–82CrossRefGoogle ScholarPubMed
Nestor, P.G.Kimble, M.Berman, I.Haycock, J.Psychosis, psychopathy and homicide: a preliminary neuropsychological inquiry Am J Psychiatry. 159 2002 138–140CrossRefGoogle ScholarPubMed
Overall, J.Gorham, D.The brief psychiatric rating scale Psychol Rep. 10 1962 799–812CrossRefGoogle Scholar
Perris, C.Kemali, D.Dencker, S.J.Malm, U.Rutz, W.Amati, A.et al.Patients admitted for compulsory treatment to selected psychiatric units in Italy and in Sweden Acta Psychiatr Scand Suppl. 316 1985 135–149CrossRefGoogle ScholarPubMed
Raja, M.Azzoni, A.Lubich, L.Aggressive and violent behaviour in a population of psychiatric inpatients Soc Psychiatr Epidemiol. 32 1997 428–434Google Scholar
Soyka, M.Substance misuse, psychiatric disorder and violent and disturbed behaviour Br J Psychiatry. 176 2000 345–350CrossRefGoogle ScholarPubMed
Swanson, J.W.Holzer, C.Gantu, V.K.Jono, R.T.Violence and psychiatric disorder in the community: evidence from the epidemiologic catchment area surveys Hosp Community Psychiatry. 41 1990 761–770Google ScholarPubMed
Swanson, J.W.Swartz, M.S.van Dorn, R.A.Elbogen, E.B.Wagner, H.R.Rosenheck, R.A.et al.A national study of violent behaviour in person with Schizophrenia Arch Gen Psychiatry. 63 2006 490–499CrossRefGoogle ScholarPubMed
Tiihonen, J.Isohanni, M.Rasanen, P.Koiranen, M.Moring, J.Specific major mental disorders and criminality: a 26 years prospective study of the 1966 northern Finland birth cohort Am J Psychiatry. 154 1997 840–845Google Scholar
Volavka, J.Laska, E.Baker, S.Meisner, M.Czobor, P.Krivelevich, I.History of violent behaviour and schizophrenia in different cultures. Analyses based on the WHO study on determinants of outcomes of severe mental disorders Br J Psychiatry. 171 1997 9–14CrossRefGoogle Scholar
Wallace, C.Mullen, P.Burgess, P.Serious criminal offending and mental disorder. Case linkage study Br J Psychiatry. 172 1998 477–484CrossRefGoogle ScholarPubMed
Wallace, C.Mullen, P.E.Burgess, P.Criminal offending in schizophrenia over a 25-year period marked by deinstitutionalization and increasing prevalence of comorbid substance use disorders Am J Psychiatry. 161 2004 716–727CrossRefGoogle Scholar
Walsh, E.Buchanan, A.Fahy, T.Violence and schizophrenia: examining the evidence Br J Psychiatry. 180 2002 490–495CrossRefGoogle ScholarPubMed
Walsh, E.Gilvarry, C.Samele, C.Harvey, K.Manley, C.Tattan, T.et al.Predicting violence in schizophrenia: a prospective study Schizophr Res. 67 2004 247–252CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.