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Ranu J, Kalebic N, Melendez-Torres GJ, Taylor PJ. Association Between Adverse Childhood Experiences and a Combination of Psychosis and Violence Among Adults: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:2997-3013. [PMID: 36117458 DOI: 10.1177/15248380221122818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Relationships have been well established between adverse childhood experiences (ACEs) and later psychosis (29 systematic reviews) or violence (4 systematic reviews). To date, just one review has explored childhood maltreatment, specifically, and violence risk with psychosis. We conducted a systematic review and meta-analyses of a wider range of ACEs and later psychosis with actual violence compared with psychosis alone, violence alone or neither, completing searches in January 2021. In all, 15 studies met inclusion criteria, but only six included all four groups of interest. Two substantial studies recorded ACEs from sources independent of those affected and probably before emergent psychosis or violence; others relied on retrospective recall. Meta-analyses were possible only for within-psychosis-group comparisons; histories of physical abuse, sexual abuse, and having a criminal/violent parent or living with family alcohol/drug use were each associated with around twice the odds of psychosis with violence as psychosis alone. Although ACE measures in the four-way comparisons were too divergent for firm conclusions, abuse histories, and parental criminality emerged as likely antecedents, one study evidencing psychosis as mediating between ACEs and violence. Without longitudinal prospective study, pathways between ACEs and later problems remain unclear. Our findings add weight to the case for exploring ACEs in addition to abuse as possible indicators of later violence among people with psychosis and for trauma-informed interventions, which is important because some people are reluctant to disclose abuse histories.
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Flannery RB, Flannery GJ. Characteristics of International Assaultive Psychiatric Patients: Review of Published Findings, 2017-2022. Psychiatr Q 2023; 94:559-568. [PMID: 37667138 DOI: 10.1007/s11126-023-10050-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/06/2023]
Abstract
Since the 1960s, empirical research has focused on a better understanding of the characteristics of assaultive psychiatric patients. International research from 1960 to 2017 indicated that male and female patients with schizophrenia and substance use disorder presented the greatest risk for assault with nursing personnel being at higher risk. This present review of studies sought to assess the latest research findings on assaultive patients for the most recent five-year period, 2017-2022. It was hypothesized that patients with schizophrenia and substance use disorders would present the greatest assault risk for nursing personnel. The studies in this review supported this hypothesis. Assaults by patients with schizophrenia and substance abuse has been a consistent finding worldwide for 62 years of published research. Explanations for these findings, the possible role of posttraumatic stress disorder (PTSD) in assaultive patients, and an updated methodological review are presented.
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Affiliation(s)
- Raymond B Flannery
- University of Massachusetts Chan Medical School The ASAP Program, 7 Westchester Road, Newton, MA, 02458, USA.
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3
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van Beek J, Meijers J, Scherder EJA, Harte JM. Aggressive Incidents by Incarcerated People With Psychiatric Illness and Their Relationship With Psychiatric Symptoms. JOURNAL OF FORENSIC NURSING 2023; 19:E30-E38. [PMID: 37590946 DOI: 10.1097/jfn.0000000000000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
AIM A prospective design was used to investigate the relationship of current psychiatric symptoms of incarcerated people with serious mental illness (SMI) and aggressive behavior on a penitentiary ward for crisis intervention. METHODS One hundred sixty detainees with SMI, detained in a high-security penitentiary psychiatric facility, were screened every 2 weeks with the Brief Psychiatric Rating Scale-Extended (BPRS-E) by trained clinicians, to ensure that the data on psychiatric symptoms were up-to-date. Aggressive behavior was registered with the Staff Observation Aggression Scale-Revised. A binary logistic regression analysis was performed to examine the relationships between factor scores of the BPRS-E and aggressive behavior. RESULTS Significant relationships between the BPRS-E factor hostility, antisocial traits, and aggressive incidents were found, but not between the positive symptoms or manic factor scores and aggressive incidents. DISCUSSION Symptoms of SMI measured with the BPRS-E did not help to explain the occurrence of aggressive behavior. This is not in line with what is commonly found. The implication is that it can be expected that this population will display aggressive behavior but that symptoms do not help in predicting when this will occur. In addition, hostility and antisocial traits were related to aggressive behavior. For this specific population, an interactional approach might be more effective in the management of aggression than treatment of symptoms of SMI.
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Affiliation(s)
| | | | - Erik J A Scherder
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam
| | - Joke M Harte
- Department of Criminal Law and Criminology, Faculty of Law, Vrije Universiteit Amsterdam
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Gao L, Yang R, Fan HZ, Wang LL, Zhao YL, Tan SP, Xiao CL, Zhou SJ. Correlation Between Aggressive Behavior and Impulsive and Aggressive Personality Traits in Stable Patients with Schizophrenia. Neuropsychiatr Dis Treat 2023; 19:801-809. [PMID: 37077708 PMCID: PMC10106313 DOI: 10.2147/ndt.s404176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/05/2023] [Indexed: 04/21/2023] Open
Abstract
Purpose To explore the correlation between aggressive behavior and impulsive and aggressive personality traits in inpatients with schizophrenia. Methods In total, 367 inpatients with schizophrenia were divided into two groups: the aggressive group and the non-aggressive group. We assessed inpatients' psychotic symptoms as well as their aggressive and impulsive personality traits using the Positive and Negative Symptom Scale, the Barratt Impulsiveness Scale, and the Buss-Perry Aggression Questionnaire. Results Compared with the scores of inpatients in the non-aggressive group, the total Buss-Perry Aggression Questionnaire, subscale, and Barratt Impulsiveness Scale behavioral factor scores in those in the aggressive group were higher (p < 0.05). The results of logistic regression analysis suggested that a high Positive and Negative Symptom Scale positive factor score (odds ratio = 1.07) and a high Buss-Perry Aggression Questionnaire physical aggression score (odds ratio = 1.02) were risk factors for aggressive behavior. Conclusion Hospitalized patients with schizophrenia with more severe positive symptoms and aggressive traits may be more prone to aggressive behavior.
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Affiliation(s)
- Lan Gao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Rui Yang
- Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Hong-Zhen Fan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Lei-Lei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Yan-Li Zhao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Shu-Ping Tan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
| | - Chun-Ling Xiao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
- Correspondence: Chun-Ling Xiao; Shuang-Jiang Zhou, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 10096, People’s Republic of China, Email ;
| | - Shuang-Jiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China
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Fekih-Romdhane F, Abboud C, Kossaify M, El Khoury N, Sleiman YB, Hachem D, Haddad G, Hallit S. Child abuse and aggressiveness in individuals diagnosed with schizophrenia in Lebanon. Perspect Psychiatr Care 2022; 58:2872-2880. [PMID: 35767392 DOI: 10.1111/ppc.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To identify individual and clinical risk factors of aggressiveness, including exposure to different forms of childhood trauma, in a sample of Lebanese patients with schizophrenia. METHODS A total of 131 patients diagnosed with schizophrenia participated in this cross-sectional study. RESULTS Higher physical (Beta = 0.24, p < 0.001) and sexual (Beta = 0.29, p = 0.003) abuse, alcohol drinking (Beta = 1.46, p = 0.008), having a history of head trauma (Beta = 1.10, p = 0.041), and male gender (Beta = -1.59, p = 0.009) were significantly associated with higher mean aggression scores. PRACTICAL IMPLICATIONS Our investigation of the factors linked to aggressiveness in patients with schizophrenia complement those of earlier findings, showing that the relationship between interacting individual and environmental risk factors and later aggressiveness is quite complex, and needs further longitudinal and prospective studies.
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Affiliation(s)
- Feten Fekih-Romdhane
- Department of Psychiatry "Ibn Omrane", The Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Manouba, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Cedric Abboud
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Mikhael Kossaify
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Nour El Khoury
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Yara Bou Sleiman
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Dory Hachem
- Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia
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Pisl V, Vevera J, Holas J, Volavka J. Violent behavior and the COVID-19 lockdowns: a nationwide register-based study. CNS Spectr 2022; 28:1-7. [PMID: 35922915 DOI: 10.1017/s1092852922000797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The primary aim was to test the hypothesis that physical interpersonal violence is decreased during the lockdown period in comparison with comparable control periods. The secondary aims were to explore the effects of gender and alcohol consumption on the violence during the lockdown. METHODS Nationwide records of hospitalizations secondary to an assault were analyzed using quasipoisson regression. Assault rates in two lockdown periods, defined as a national emergency state, were compared to baseline data between 2017 and 2020, controlling for seasonal fluctuations and pandemic-related effects other than lockdown. To validate the findings on independent data, differences between lockdown and baseline in Police records of violent criminality between 2017 and 2021 were examined using one-way ANOVA. RESULTS The rates of hospitalizations secondary to an assault decreased substantially during lockdowns (IRR = .43; P < .001) and the duration of lockdown did not affect assault rates (P = .07). The decrease in assault rates was more pronounced in males than females (IRR = .77; P < .05) and was weakened in patients with history of alcohol abuse (IRR = 1.83; P < .001). Violent crime rate decreased by 19% during the lockdowns compared to prepandemic baseline (P < .001). CONCLUSION We found that physical interpersonal violence decreased during the COVID-19 lockdown periods. The reduction is significantly greater in males. Emerging evidence suggests an increased risk of alcohol use and intoxication during the lockdowns. Violent crime rate decreased during the lockdown.
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Affiliation(s)
- Vojtech Pisl
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jan Vevera
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jakub Holas
- Institute of Criminology and Social Prevention, Prague, Czech Republic
| | - Jan Volavka
- Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Emeritus, Department of Psychiatry, New York University, NY, USA
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Juríčková V, Linhartová P, Adámek P, Nichtová A, Figueroa J, Páv M, Preiss M, Vevera J. Behavioral inhibition in neutral and emotional contexts in acutely violent patients with schizophrenia spectrum disorders. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03415-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mlada K, Formanek T, Vevera J, Latalova K, Winkler P, Volavka J. Serious physical assault and subsequent risk for rehospitalization in individuals with severe mental illness: a nationwide, register-based retrospective cohort study. Ann Gen Psychiatry 2021; 20:44. [PMID: 34537054 PMCID: PMC8449895 DOI: 10.1186/s12991-021-00358-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Victimization is associated with worse social and clinical outcomes of individuals with severe mental illness (SMI). A relapse of SMI may be one of the clinical consequences of assaultive trauma. As far as we know, there is no published study that analyzes nationwide health registers to assess the risk of SMI rehospitalization following assault. AIM We aimed to assess whether exposure to assault is associated with an increased risk of psychiatric hospitalization in those with SMI. METHODS We utilized data from the Czech nationwide registers of all-cause hospitalizations and all-cause deaths. We defined exposed individuals as those discharged from a hospitalization for SMI between 2002 and 2007, and hospitalized for serious injuries sustained in an assault in the subsequent 7 years. For each assaulted individual, we randomly selected five counterparts, matched on SMI diagnosis, age and sex, who were not assaulted in the examined time period. We used mixed effect logistic regression to assess the effect of assault on the risk of SMI rehospitalization within the following 6 months. We fitted unadjusted models and models adjusted for the number of previous SMI hospitalizations and drug use disorders. RESULTS The sample consisted of 248 exposed and 1 240 unexposed individuals. In the unadjusted model, assaulted individuals were almost four times more likely to be rehospitalized than their non-assaulted counterparts (odds ratio (OR) = 3.96; 95% CI 2.75; 5.71). After adjusting for all covariates, the OR remained threefold higher (OR = 3.07; 95% CI 2.10; 4.49). CONCLUSION People with a history of SMI hospitalization were approximately three times more likely to be rehospitalized for SMI within 6 months after an assault than their non-assaulted SMI counterparts. Soon after a person with SMI is physically assaulted, there should be a psychiatric evaluation and a close follow-up.
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Affiliation(s)
- Karolina Mlada
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic.
- Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University, Prague, Czech Republic.
| | - Tomas Formanek
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- EpiCentre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jan Vevera
- Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University, Prague, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
- Institute for Postgraduate Medical Education Prague, Prague, Czech Republic
| | - Klara Latalova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic
- Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Petr Winkler
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jan Volavka
- Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University, Prague, Czech Republic
- Department of Psychiatry, New York University School of Medicine, New York, Emeritus, USA
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Caruso R, Antenora F, Riba M, Belvederi Murri M, Biancosino B, Zerbinati L, Grassi L. Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience. Curr Psychiatry Rep 2021; 23:29. [PMID: 33825996 PMCID: PMC8026454 DOI: 10.1007/s11920-021-01233-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience. RECENT FINDINGS A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need to undertake initiatives aimed to enhance understanding, prevention, and management of violence in general hospital settings across Europe.
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Affiliation(s)
- Rosangela Caruso
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy. .,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121, Ferrara, Italy.
| | - Fabio Antenora
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI USA ,University of Michigan Comprehensive Depression Center, Ann Arbor, MI USA ,Psycho-oncology Program, University of Michigan Rogel Cancer Center, Ann Arbor, MI USA ,Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester, Leicester, UK
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy ,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
| | | | - Luigi Zerbinati
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy ,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
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10
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Fritz M, Shenar R, Cardenas-Morales L, Jäger M, Streb J, Dudeck M, Franke I. Aggressive and Disruptive Behavior Among Psychiatric Patients With Major Depressive Disorder, Schizophrenia, or Alcohol Dependency and the Effect of Depression and Self-Esteem on Aggression. Front Psychiatry 2020; 11:599828. [PMID: 33343427 PMCID: PMC7744284 DOI: 10.3389/fpsyt.2020.599828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022] Open
Abstract
Aggressive and disruptive behavior in inpatient settings poses a serious challenge for clinical staff and fellow patients. Hence, the aim of this study was to identify different aspects of aggressive and disruptive behavior in the context of an aberrant self-esteem or clinically manifested depression as potentially influencing factors. We collected self-reported data from 282 psychiatric patients [ICD-10 diagnoses for alcohol dependency, schizophrenia or major depressive disorder (MDD)] and compared it to healthy norm groups. As expected, all three patient groups scored higher in the aggression questionnaires than the norm group. Specifically, patients with MDD exhibited significantly higher externally directed aggression, reactive aggression, and irritability compared to controls. Patients with schizophrenia displayed higher irritability, while all three groups showed distinctly higher self-aggressiveness than healthy persons. We found a lower inhibition of aggression in alcohol dependent subjects compared to both the patient groups and the norm sample. Yet, the higher the self-esteem among alcohol dependent and MDD patients, the lower were their aggression scores; similarly, a lower self-esteem among patients diagnosed with schizophrenia resulted in heighten self-aggressiveness. Thus, our data suggests that therapeutic interventions for strengthening self-esteem in patients with a diagnosis of MDD, alcohol dependency or schizophrenia could reduce certain aspects of aggressive behavior. Therefore, it seems conceivable that strengthening self-esteem in psychiatric patients could contribute to the prevention of violence in clinical practice.
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Affiliation(s)
- Michael Fritz
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Riad Shenar
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | | | - Markus Jäger
- Department of Psychiatry, Psychotherapy and Psychosomatics, District Hospital Kempten, Kempten, Germany
| | - Judith Streb
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Irina Franke
- Department of Forensic Psychiatry, Psychiatric Services Graubuenden, Cazis, Switzerland
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Wang L, Xu J, Zou H, Zhang H, Qu Y. Violence against primary caregivers of people with severe mental illness and their knowledge and attitudes towards violence: A cross-sectional study in China. Arch Psychiatr Nurs 2019; 33:167-176. [PMID: 31753224 DOI: 10.1016/j.apnu.2019.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 08/04/2019] [Accepted: 08/18/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study is to investigate the current situation of violence on primary caregivers of people with severe mental illness outside the hospital and the cognition of primary caregivers about violence among mental patients. METHODS A self-designed questionnaire was used to investigate the primary caregivers (N = 208) of people with severe mental illness in a psychiatric hospital in Beijing. RESULTS The incidence rate of violence suffered by primary caregivers was 74.03%, of which 61.54% had experienced verbal attacks, 54.33% had experienced threats, and 45.19% experienced physical attacks. Physical violence, mainly by unarmed attacks, has resulted in soft tissue injury and pain in the majority of caregivers. Multiple admission times, a lower educational level, single in marital status and involuntary hospitalizations were risk factors; growing older was protective factor. The causes of violence were dominated by mental symptoms in 120 cases (57.69%). Tolerance and avoidance were the coping styles of most caregivers adopted after violence, accounting for 51.44%. Furthermore, most of primary caregivers have limited knowledge of violence and adopted an attitude of pessimism towards patients' violence. CONCLUSIONS It was reported that violence was suffered by primary caregivers of persons with severe mental illness outside the hospital. The study indicated that formulating reasonable nursing intervention, providing health education as well as organizing training towards violence of patients are required to play an important role in effectively preventing and reducing the violence among the people with severe mental illness in China. More information and support needs to be obtained to help caregivers fulfill their duty of care outside the hospital.
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Affiliation(s)
- Lu Wang
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing 100144, China
| | - Jiangling Xu
- Department of Nursing, Anding Hospital, Capital Medical University, 5 Ankang Lane, Beijing 100088, China
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing 100144, China.
| | - Haiyu Zhang
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing 100144, China
| | - Yanhua Qu
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing 100144, China
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