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De-escalation techniques for psychosis-induced aggression or agitation
Maolin Du1, Xuemei Wang1, Shaohua Yin1
1School of Public Health, Inner Mongolia Medical University, Jinshan Development District,, Hohhot, Inner Mongolia, China, 010110.
The Cochrane Database of Systematic Reviews
|April 4, 2017
Summary
De-escalation techniques are considered good practice for managing aggression in psychosis but lack randomized trial evidence. Further research is needed to support this widely accepted clinical approach.
Area of Science:
- Psychiatry
- Clinical Psychology
- Behavioral Science
Background:
- Aggression is a disposition to inflict harm, behaviorally or verbally.
- De-escalation is a psychosocial intervention for managing aggressive behavior.
- Secondary strategies like rapid tranquilization should follow de-escalation failures.
Purpose of the Study:
- To investigate the effects of de-escalation techniques.
- Focus on short-term management of aggression or agitation due to psychosis.
Main Methods:
- Searched Cochrane Schizophrenia Group's Study-Based Register of Trials.
- Included randomized controlled trials (RCTs) of de-escalation for adults with psychosis-induced aggression.
- Excluded studies not meeting RCT criteria after initial review.
Main Results:
- Identified 345 citations; only one was potentially suitable.
- The single potentially suitable study was excluded as it was not an RCT.
- No RCTs met the inclusion criteria for data extraction and analysis.
Conclusions:
- De-escalation for psychosis-induced aggression is accepted clinical practice but lacks RCT support.
- The lack of research in this area is unclear and may stem from funding or ethical concerns.
- Addressing this research gap requires collaboration among funders, ethics committees, clinicians, and service users.