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The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress

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Aggression in psychiatry wards: a systematic review.

Cesare Maria Cornaggia¹, Massimiliano Beghi, Fabrizio Pavone

¹Department of Clinical Psychiatry, University of Milano-Bicocca, Monza, Italy; Organic Psychiatry Unit, Zucchi Clinical Institute, Carate Brianza, Italy.

Psychiatry Research

|January 18, 2011

Summary

Aggression and violence are common in psychiatric settings, with staff health impacted by frequent exposure. A positive staff environment is more effective for prevention than other strategies.

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Area of Science:

Psychiatry
Mental Health Research
Clinical Psychology

Background:

Aggression and violence are frequent occurrences in psychiatric inpatient settings.
Nurses exposed to frequent violent incidents report lower general health levels.
Discrepancies exist between patient and staff perceptions regarding violence predictors.

Purpose of the Study:

To identify predictors of aggression and violence in unselected psychiatric inpatient populations.
To analyze factors contributing to aggression in psychotic patients.
To evaluate the effectiveness of different prevention strategies in psychiatric wards.

Main Methods:

Systematic literature search of PubMed, Embase, and PsycInfo databases (1990-2010).
Inclusion of studies on adult psychiatric inpatients, excluding specific subgroups.
Analysis of 66 studies for general populations and 12 studies for psychotic patients.

Main Results:

Frequent predictors of aggression/violence include prior episodes, impulsiveness, longer hospitalization, non-voluntary admission, and same-gender victim-aggressor pairs.
Factors like alcohol/drug misuse, psychosis diagnosis, younger age, and suicide risk showed weaker associations.
In psychotic patients, alcohol/drug misuse, hostility, paranoia, and acute psychosis were key factors.
A harmonious staff working climate appears more effective in preventing aggression than other methods.

Conclusions:

Understanding predictors of inpatient aggression is crucial for targeted interventions.
A positive and harmonious staff environment is a key factor in mitigating aggression in psychiatric wards.
Further research is needed to refine prevention strategies and improve staff well-being.