The relationship between patients' gender and violence leading to staff injuries

Although recent research has found similar rates of violence by female and male patients who have serious mental disorders, it is less clear whether violence by female patients is as likely to result in injury as violence by male patients. This study examined the relationship between violent patients' gender and injury to staff members on an inpatient unit.

All injuries to staff caused by violent behavior by patients on a locked university-based short-term inpatient unit were identified in a search of institutional records from October 1988 to June 1999. We reviewed the medical charts of the 76 patients who injured staff members to compare their demographic and clinical characteristics with those of 314 patients hospitalized during the same period who did not injure staff.

Nearly half of the injuries (45 percent) were caused by female patients. Moreover, the proportion of injuries caused by female and male patients was similar to the proportion of females and males in the comparison group. Multivariate logistic regression analysis showed that patients' gender was not associated with injury to staff, even when the analyses controlled for other correlates of violence such as history of violence, violent thought content expressed in the admission mental status examination, and history of noncompliance with medication.

The findings suggest that injuries to staff members on a unit treating both men and women are as likely to be caused by violence by female patients as by male patients. When a female patient exhibits signs of an elevated risk of violence, the significance of that risk should not be discounted on the basis of her gender.