Aggressive behaviour and mental illness: a study of in-patients at Aro Neuropsychiatric Hospital, Abeokuta

To determine the magnitude and pattern of aggressive behaviour among psychiatric in-patients and identity associated socio-demographic and clinical factors.

The study was cross-sectional in design. Among patients admitted to the Neuro-psychiatric Hospital, Aro (and its Lantoro annex), Abeokuta between January 1 to December 31, 2005, those who manifested aggressive behaviour were identified. Each was evaluated by the medical team, and a questionnaire detailing socio-demographic and clinic variables was administered on them.

A total of 305 patients comprising 213 (69.8%) males and 92 (30.2%) females were managed as inpatients during the period of the survey. Out of these, 43 patients manifested aggressive behaviour representing a rate of 13.8%. The aggressive patients consisted of 26 males and 17 females, representing rates of 12.2 and 18.5 percent for the sexes respectively. Of the 11 diagnoses entered for all the patients, only 3 were associated with aggressive behaviour. These included schizophrenia, 21 patients (48.8%); bipolar manic illness, 12 patients (27.9%) and co-morbid substance use (mainly cannabis) and mental disorder, 10 patients (22.3%). Nursing personnel constituted the majority of target of aggression. Unemployment was the only socio demographic variable observed with significant positive relationship with aggressive behaviour. In addition, the commonest probable precipitants of aggressive behaviour included hallucinations, clamouring for discharge and attempting to abscond, reaction to confrontational interview, impulsivity and reaction to unmet demands.

Mental health practitioners (especially nurses) should be equipped with necessary skills in managing aggressive and potentially aggressive patients. The present observations may be useful in raising the suspicion of care providers on potentially aggressive patients for preventive purpose.