Occupational risk due to violence in a psychiatric ward

This study aimed to elucidate causes of aggression from clinical records of a psychiatric ward of a major urban public hospital where aggression towards Health Care Workers [HCWs] was the second leading cause of hospital work-related injuries after needlesticks.

Psychiatric patients'clinical records for the period 2002-2005 were examined and coded. Data were analysed with the case-control approach to identify the determinants of the aggressive behavior towards HCWs, after adjustment for age, gender, nationality and diagnosis of the patients.

We examined 2.196 records and identified 321 individuals who had become violent at least once towards nurses, pshysicians or other patients or relatives during their hospitalization. The victims of the aggressive behavior were mainly nurses. A history of involuntary admission was strongly associated with aggression [OR 4.5, 95% CI 3.4-5.9]. Diagnosis, gender and nationality of the patients were not predictive of aggressive behavior towards HCWs.

Involuntary admission to a psychiatric ward might be a cause of violent behavior towards health care workers, mainly nurses.