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Garrote-Cámara ME, Juárez-Vela R, Rodríguez-Muñoz PM, Pérez J, Sánchez-González JL, Rubinat-Arnaldo E, Navas-Echazarreta N, Sufrate-Sorzano T, Santolalla-Arnedo I. NANDA nursing diagnoses associated with the occurrence of psychomotor agitation in patients with severe mental disorder: a cross-sectional study. BMC Nurs 2023; 22:292. [PMID: 37641035 PMCID: PMC10464465 DOI: 10.1186/s12912-023-01434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Psychomotor agitation is increased psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by overreacting to intrinsic and extrinsic stimuli, experiencing stress and/or cognitive impairment. the aim was to analyse the association of nursing diagnoses with the disinhibition dimension, the aggressiveness dimension and the lability dimension of the Corrigan Agitated Behaviour Scale. METHODS This study was conducted in Spain using a multicentre cross-sectional convenience sample of 140 patients who had been admitted to psychiatric hospital units and had presented an episode of psychomotor agitation between 2018 and 2021. RESULTS The Corrigan Agitated Behaviour Scale was used to assess psychomotor agitation. Associated nursing diagnoses, violence directed at professionals and the environment are shown to be predictive values for the severity of the agitation episode. Moderate-severe psychomotor agitation episodes are shown as predictors of violence directed mainly at professionals and the environment. CONCLUSIONS There is an urgent need for mental health nurses to have knowledge of the extended clinic in order to care for users and improve their health conditions in dealing with people, with their social, subjective and biological dimension.
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Affiliation(s)
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, Logroño, La Rioja, Spain.
| | | | - Jesús Pérez
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Garrote-Cámara ME, Gea-Caballero V, Sufrate-Sorzano T, Rubinat-Arnaldo E, Santos-Sánchez JÁ, Cobos-Rincón A, Santolalla-Arnedo I, Juárez-Vela R. Clinical and Sociodemographic Profile of Psychomotor Agitation in Mental Health Hospitalisation: A Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15972. [PMID: 36498042 PMCID: PMC9735933 DOI: 10.3390/ijerph192315972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Psychomotor agitation is characterised by an increase in psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by over-reacting to both intrinsic and extrinsic stimuli, experiencing stress and/or altered cognition. The objective of this study is to assess the clinical and sociodemographic profile of psychomotor agitation in patients with severe mental disorders. The study was carried out in Spain by means of multicentre cross-sectional convenience sampling involving 140 patients who had been admitted to psychiatric hospital units and had experienced an episode of psychomotor agitation between 2018 and 2021.Corrigan's Agitated Behaviour Scale was used to assess psychomotor agitation. The results show that the predominant characteristic in psychomotor agitation is aggressiveness, which is also the most reported factor in patients with severe mental disorder. Patients who also have anxiety develop psychomotor agitation symptoms of moderate/severe intensity. The clinical and sociodemographic profile found in our study is consistent with other studies on the prevalence of psychomotor agitation.
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Affiliation(s)
- María Elena Garrote-Cámara
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Vicente Gea-Caballero
- Research Group on Community Health and Care, Faculty of Health Science, Valencia International University, 46002 Valencia, Spain
| | - Teresa Sufrate-Sorzano
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Esther Rubinat-Arnaldo
- Society, Health, Education and Culture Study Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25003 Lleida, Spain
| | | | - Ana Cobos-Rincón
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Iván Santolalla-Arnedo
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Raúl Juárez-Vela
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
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Tamayo Acosta JC, Sosa Gomez A, Gonzalez Diaz L, Rivera Rodriguez G, Acosta Guillot M. Management of Psychosis in the Setting of Binge Eating, Mania, and Extrapyramidal Side Effects. Cureus 2022; 14:e26846. [PMID: 35974863 PMCID: PMC9375515 DOI: 10.7759/cureus.26846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/05/2022] Open
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Pan YZ, Xie XM, Tang YL, Ng CH, Wang G, Xiang YT. A comparison of aggression between patients with acute schizophrenia and mania presenting to psychiatric emergency services. J Affect Disord 2022; 296:493-497. [PMID: 34653702 DOI: 10.1016/j.jad.2021.09.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/05/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Aggression is common and challenging in psychiatric emergency departments (PED). However, the prevalence of aggression and its correlates in PED patients are not well documented. This study compared the prevalence of aggression between patients with acute schizophrenia and manic episodes. METHODS In this cross-sectional study, patients at a psychiatric emergency department were assessed with measurements of aggression, psychotic and manic symptoms. RESULTS A total of 4,172 patients were included. The prevalence of aggression was 54.8% (95%CI=53.3%-65.2%) in the whole sample, with 48.0% (95%CI=45.8%-50.1%) in patients with an acute schizophrenia episode, and 61.8% (95%CI=59.8%-63.9%) in patients with a manic episode. Multiple logistic regression analysis revealed that, within the acute schizophrenia episode group, male gender (OR=1.47, P<0.01), involuntary admission (OR=3.61, P<0.01) and more severe manic symptoms (OR=1.30, P<0.01) were significantly associated with aggression. Within the manic episode group, living in Beijing (OR=1.51, P<0.01), unemployment (OR=1.34, P=0.03), involuntary admission (OR=7.93, P<0.01), lower education (OR=0.95, P=0.01) and more severe psychotic symptoms (OR=1.05, P<0.01) were significantly associated with aggression. CONCLUSION In this study, aggression appeared to be more common among patients with a manic episode than those with an acute schizophrenia episode. Considering the significant risk of aggression on psychiatric emergency care, appropriate and effective management of aggression in this population group need to be developed.
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Affiliation(s)
- Yi-Zhu Pan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-Meng Xie
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA; Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Garrote-Cámara ME, Santolalla-Arnedo I, Ruiz de Viñaspre-Hernández R, Gea-Caballero V, Sufrate-Sorzano T, del Pozo-Herce P, Garrido-García R, Rubinat-Arnaldo E, Juárez Vela R. Psychometric Characteristics and Sociodemographic Adaptation of the Corrigan Agitated Behavior Scale in Patients With Severe Mental Disorders. Front Psychol 2021; 12:779277. [PMID: 34955998 PMCID: PMC8693627 DOI: 10.3389/fpsyg.2021.779277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Severe mental disorder (SMD) is understood in a first approximation as a disorder of thought, emotion, or behavior of long duration, which entails a variable degree of disability and social dysfunction. One of the most widely used assessment scales for agitated behavior, in its English version, is the Corrigan Agitated Behavior Scale (ABS); several studies have demonstrated solid psychometric properties of the English version, with adequate internal consistency. Objective: The objective of this study was to evaluate the psychometric properties of the Spanish version of the ABS Corrigan scale, in a sample of patients with severe mental disorders. The psychometric analyses of the Spanish version of the ABS Corrigan included tests of the reliability and validity of its internal structure. Results: The structure of the factorial loads of the analyzed elements is consistent with the hypothesized three-dimensional construction referred to in the original ABS. The results suggest that the reliability and validity of the three dimensions are acceptable (First 0.8, Second 0.8, and Third 0.7). The internal consistency of the Spanish version of the complete ABS and of each of the three domains that compose it is high, with values very close to those found in the original version, with approximate figures of 0.9. Conclusion: In our study, the three domains aim to explain 64.1% of the total variance of the scale, which exceeds the 50% found in the original version.
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Affiliation(s)
- María Elena Garrote-Cámara
- Mental Health Center of Albelda de Iregua, Riojan Health Service, Government of La Rioja, La Rioja, Spain
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
| | - Iván Santolalla-Arnedo
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
- Care Research Group (GRUPAC) - University of La Rioja, La Rioja, Spain
| | - Regina Ruiz de Viñaspre-Hernández
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
- Care Research Group (GRUPAC) - University of La Rioja, La Rioja, Spain
| | | | - Teresa Sufrate-Sorzano
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
- Care Research Group (GRUPAC) - University of La Rioja, La Rioja, Spain
| | - Pablo del Pozo-Herce
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
- Care Research Group (GRUPAC) - University of La Rioja, La Rioja, Spain
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Rebeca Garrido-García
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
- Care Research Group (GRUPAC) - University of La Rioja, La Rioja, Spain
- Najera Health Center, Riojan Health Service, Government of La Rioja, La Rioja, Spain
| | - Esther Rubinat-Arnaldo
- Research Group of Health Care (GRECS) - IRBLleida, Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Research Group Society, Health, Education and Culture (GESEC), University of Lleida, Lleida, Spain
- Center for Biomedical Research Network on Diabetes and Associated Metabolic Diseases (CIBERDEM), Carlos III Health Institute, Barcelona, Spain
| | - Raúl Juárez Vela
- Group of Research in Sustainability of the Health System, Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
- Care Research Group (GRUPAC) - University of La Rioja, La Rioja, Spain
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Abstract
PURPOSE OF REVIEW Agitation associated with schizophrenia remains an important clinical concern and if not managed effectively, can escalate into aggressive behavior. This is a review of the recent biomedical literature on agitation in individuals with schizophrenia. RECENT FINDINGS Themes in the recent literature include consideration of comorbidities such as cigarette smoking and cannabis use. Surveys reveal that pharmacological approaches to manage agitation have changed little, with haloperidol remaining in common use and intramuscular administration of antipsychotics and/or benzodiazepines being frequently administered to more severely agitated/aggressive individuals. Of note, ketamine has been recently adopted for use in severe agitation in medical emergency departments, but the risk of this medication for people with schizophrenia is unclear. At present, inhaled loxapine remains the only rapidly acting noninjectable FDA-approved treatment for agitation associated with schizophrenia. In development is an intranasal formulation for olanzapine (a well characterized atypical antipsychotic already approved to treat agitation) and a sublingual film for dexmedetomidine (an α2-adrenergic agonist used as an anesthetic and now being repurposed). SUMMARY Comorbidities can contribute to agitation and can make an accurate differential diagnosis challenging. The ongoing development of rapidly acting novel formulations of antiagitation medications, if successful, may facilitate clinical treatment by providing additional options.
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