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Published on: November 21, 2013
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Risk assessment for aggressive behaviour in schizophrenia
Maritta Välimäki1, Tella Lantta2, Raija Kontio2
1School of Public Health, University of Helsinki, Helsinki, Finland.
The Cochrane Database of Systematic Reviews
|May 2, 2024
Summary
Structured risk assessment methods may reduce aggressive incidents in patients with schizophrenia. However, current evidence is insufficient to confirm their effectiveness, and further research is recommended to combine these methods with interventions.
Area of Science:
- Psychiatry
- Clinical Psychology
- Evidence-Based Medicine
Background:
- Aggressive behavior in schizophrenia is a public concern.
- Structured risk assessment aims to identify individuals at high risk of violence.
- Existing interventions are often time-consuming and require extensive training.
Purpose of the Study:
- To evaluate the effectiveness of structured aggression/violence risk assessment methods for individuals with schizophrenia.
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched multiple databases including MEDLINE, Embase, and PsycINFO.
- Extracted data and assessed risk of bias using the GRADE approach.
Main Results:
- One RCT (1852 participants) suggested structured risk assessment may reduce severe aggression events (RR 0.59, 95% CI 0.37 to 0.93; moderate-certainty evidence).
- Limited or no effect was observed on the use of seclusion.
- No clear effect on adverse events like escape, falls, or choking was found.
Conclusions:
- Current evidence is insufficient to definitively conclude the effectiveness of structured risk assessment for schizophrenia.
- Future research should explore combining structured risk assessment with interventions to prevent aggression.
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