Conference paper
INVOLUNTARY HOSPITALIZATION AND VIOLENT BEHAVIORS: MEDICAL ACT OR SOCIAL CONTROL? A 3-year retrospective analysis
Giulia Menculini
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Norma Verdolini
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy; Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Catalonia, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Barcelona, Catalonia, Spain
Roberta Lanzi
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Giorgio Pomili
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Patrizia Moretti
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Alfonso Tortorella
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Abstract
Background: The present retrospective study is aimed at assessing the clinical and psychopathological correlates of violent
behaviors in a sample of acute involuntary committed inpatients.
Subjects and methods: Involuntary inpatients were retrospectively assessed for the presence of violent behaviors. Patients with
and without overt hetero-aggressive behaviors were compared according to socio-demographic, clinical and psychopathological
features. A stepwise backward logistic regression was performed in order to assess the variables most associated with the
perpetration of violent acts. The sample of violent patients was then divided in two subgroups on the basis of the presence/absence of a serious mental illness (SMI). Bivariate analyses were performed between SMI and non-SMI violent patients.
Results: In the present sample of 160 inpatients, 88 (55%) perpetrated violent acts. Subjects who performed violence presented a higher rate of mood stabilizers prescription (p=0.038). The PANSS-excited component was positively associated with violent
behaviors (p=0.027, Odds Ratio (OR)=1.14, Confidence Interval (CI) 1.01-1.28), whilst the PANSS-depressed/anxiety factor
displayed a negative association (p=0.015, OR=0.78, CI 0.64-0.95). Violent inpatients diagnosed with SMI presented higher
rehospitalization rate (p=0.009), longer length of stay (p=0.005), more frequent long-acting injectable antipsychotics prescription (p<0.001) and a higher positive symptoms severity as measured by the PANSS-positive factor (p=0.049).
Conclusions: The clinical population of acute psychiatric inpatients performing violent behavior represents a specific and
heterogeneous subgroup of patients for which prevention and treatment strategies should be addressed.
Keywords
violent behavior; aggression; psychiatric inpatients; involuntary commitment
Hrčak ID:
262975
URI
Publication date:
21.11.2018.
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