Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience

Abstract

Purpose of Review We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience. Recent Findings A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Summary Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need to undertake initiatives aimed to enhance understanding, prevention, and management of violence in general hospital settings across Europe.

The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey

“…Wu et al recently reported that 20.86% of physicians in general hospitals had encountered MD, which was much lower than our findings. 20 This gap may be due to the characteristics of the patients and their families, 33 the nature of psychiatric service, and the relative shortage of mental health resources. 34 There are several limitations about this study.…”

Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

“…Nurses reported more positive attitudes toward patients who become aggressive or violent when they feel vulnerable, helpless, and afraid as measured by the ATABQ. Cognitive impairment, confusion, delirium, dementia, and alcohol and illegal drug intoxication or withdrawal are often detected in violent patients [ 1 , 20 , 21 , 79 , 80 ]. These illnesses and cognitive status limit patients’ ability to communicate effectively and understand the situation as the disease or discomfort progresses and its context during stay in ED.…”

Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study

“…Extant research indicated that internal risk factors encompassed clinical and personal factors. Other studies have identified alcohol intoxication, substance abuse, and mental illness as clinical factors for PVV among perpetrators [ 21 , 22 ]. Regarding personal factors or behavioral problems for PVV, male and younger patients/visitors, individual propensity to anger, hostile attributions, disease and discomfort, and low socioeconomic status are all possible factors [ 22 , 25 ].…”

“…Other studies have identified alcohol intoxication, substance abuse, and mental illness as clinical factors for PVV among perpetrators [ 21 , 22 ]. Regarding personal factors or behavioral problems for PVV, male and younger patients/visitors, individual propensity to anger, hostile attributions, disease and discomfort, and low socioeconomic status are all possible factors [ 22 , 25 ]. Environmental and process issues, and the sources of violence which constituted as external risk factors might simultaneously acted as triggers for violence in ED.…”

“…These persistent stressful situations increase the risk for PVV ubiquitous [ 7 , 19 , 20 ]. Studies conducted in EDs have suggested that long wait times, excess noise, overcrowding, feeling a lack of caring, being given bad news related to diagnosis or prognosis, and ineffective interpersonal relationships are all possible risk factors for WPV [ 7 , 21 , 22 , 23 ].…”