Psychiatrists' accuracy in predicting violent behavior on an inpatient unit

Courts and legislators continue to assume psychiatrists are able to predict dangerousness, but research has shown they have no special ability to do so. In this study, two psychiatrists examined 47 new inpatient admissions to a short-term psychiatric treatment unit and predicted whether they would commit battery or demonstrate threatening or suicidal behavior within seven days. The psychiatrists were not accurate in predicting battery or suicidal behavior but had some efficacy in predicting threatening behaviors. The presence of assaultive or threatening behavior on admission, hallucinations on mental status examination, and a discharge diagnosis of mania were useful for predicting battery. A discharge diagnosis of mania was useful for predicting threatening behavior. The use of likelihood ratios to conceptualize predictive data is described.