2124 – Assessment and treatment of patients with violent behaviors in emergency psychiatry. The HCR-20 violence risk assessment scheme

Abstract

IntroductionViolent behavior of patients is a common problem in emergency psychiatry and evaluation, diagnosis, management and treatment of which is very difficult.The absence of a test that could be used to predict violent behavior hampers proper decision in the case of emergency admissions, as well as discharge from the hospital. The application of such a test would upgrade assessment offering solve this problem.ObjectiveTo identify risk and protective factors of violent behaviors : to establish the degree to which the HCR-20 predicts the frequency and severity of violent behavior; to examine the predictive validity of the scales of the HCR-20.GoalImprove assessment, management and treatment of patients with violent behaviors in the psychiatric ward.MethodProspective cohort study, during 24 weeks. Psychiatric evaluation based on structural clinical interviews and questionnaires related to violent behaviors and risk factors were conducted to patients admitted in psychiatric hospital on UHC “Mother Tereza” Tirana.ResultsAccording to our data, the relationship between violence and mental illness vary considerably across different diagnoses.The highest rate of violence is reported in subjects with substance abuse disorder and antisocial personality disorder followed by Bipolar disorder and psychotic patients.Among the risk factors verified so far, the past violence behaviors reported show the highest predictive value.ConclusionsHCR-20 tool has currently shown good results to roughly estimate probability of future violence and taking appropriate measures in order to prevent unwanted consequences.