Violence risk assessment instruments are increasingly being used. Their use has, however, mostly been confined to forensic psychiatry for assessing the risk among perpetrators to repeat violent acts. In general psychiatry, very few studies of violence risk among discharged persons from acute inpatient units have been conducted. The available instruments are extensive and time consuming. This study aimed at the construction of a brief checklist. A 33-item scale, the PS (Preliminary Scheme), strongly influenced by the established HCR-20 (Historical, Clinical and Risk Management Assessment Scheme) was developed to undergo logistic regression analysis and possible item reduction. One hundred and ten patients from an acute inpatient unit, scored with PS at discharge, were monitored for violent episodes throughout the following year. Risk assessments and violence registrations were then compared. Of the 110 patients, 29 (26%) had acted violently during the follow-up, with the PS showing a definite association with post-discharge violence. Receiver operating characteristics (ROC) for the instrument yielded an area under the curve (AUC) of 0.71 (P<0.01). Regression analysis indicated that the number of PS items could be strongly reduced without losing predictive validity. Even a four-item checklist showed a higher AUC (0.77) than the PS did with all 33 items. The four items were: 1) Previous violence, 2) Substance use problems, 3) Lack of empathy and 4) Stress. The development of a brief risk assessment instrument with good predictive properties seems possible. Further clinical trials are planned. Ethical aspects of violence prediction must always be considered.
157 males and females divided into four psychodiagnostic groups have been examined according to a specially defined physiotherapeutic method (ad modum Sundsvold). In this paper, results from the evaluation of passive and active movements in five body regions in both males and females are presented (36 variables). In all five body regions, significant differences concerning inhibited movements between the four groups were found, the psychotic group being most inhibited followed by the ego-weak neurotic group, the substance-abusing group and the healthy control group. With regard to the slack movements, significant differences were found in the two extremity regions. The substance-abusing group had the most slack movements, next came the ego-weak neurotic group, the psychotic group and lastly the control group. Men were more inhibited than women in three regions, mostly in the lumbosacral region. This finding is discussed in relationship to the high frequency of lumbar disc herniation in men. Women were more significantly inhibited in the temporomandibular region, a finding which may explain why mostly women are suffering from the myofacial pain syndrome.
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