Violence and mental disorders. A retrospective study of people in charge of a community mental health center

Pinna, Federica; Tusconi, Massimo; Dessì, Claudio; Pittaluga, Giuseppe; Fiorillo, Andrea; Carpiniello, Bernardo

doi:10.1016/j.ijlp.2016.02.015

Cited by 22 publications

(12 citation statements)

References 48 publications

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“…Our findings show that outpatients with a lifetime history of violence under care in Italian DMHs had more frequent and more severe episodes of aggression and violence compared to controls. This is in line with Italian retrospective studies on outpatients conducted after the reform of Law 81/2014 [9,10]. On the other hand, this finding is at odds with the results of the first wave of the VIORMED project, in which 82 patients living in RFs with an history of violence were compared to 57 patients with no such history.…”

Section: Discussionsupporting

confidence: 72%

Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy

et al. 2019

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Background The management of mentally ill offenders in the community is one of the great challenges imposed on community psychiatry. Aim The aim of this study was to analyze the association between sociodemographic, clinical, and psychosocial factors and violent behavior in a sample of outpatients with severe mental disorders. Method This was a prospective cohort study with a baseline cross-sectional design used to provide a detailed analysis of patients’ profiles, followed by a longitudinal design to measure aggressive and violent behavior during a 1-year follow-up. Patients with severe mental disorders, with or without a history of violence, were enrolled in four Italian Departments of Mental Health and underwent a comprehensive multidimensional assessment. Results The sample included 247 outpatients, for a total of 126 cases and 121 controls. Compared to controls, patients with a history of violence had a greater frequency of lifetime domestic violence, a greater lifetime propensity to misuse substances, and a higher number of compulsory admissions. The forthnightly monitoring during the 1-year follow-up did show statistically significant differences in aggressive and violent behavior rates between the two groups. Verbal aggression was significantly associated with aggression against objects and physical aggression. Moreover, outpatients with an history of violence showed statistically significant higher MOAS scores compared to both residential patients with an history of violence, assessed in the first wave of this project, and all controls. Conclusions Patients with a history of violence had specific characteristics and showed a greater occurrence of additional community violence during a 1-year observation period. Our results may assist clinicians in implementing standardized methods of patient assessment and violence monitoring in outpatient mental health services and may prompt improved collaboration between different community services.

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Section: Discussionsupporting

confidence: 72%

Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy

et al. 2019

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“…People with a history of externally directed aggression are more prone to repeat similar acts against others 11 , or to engage in SHb 12 . Moreover, those who attempt suicide are at risk of repeating this behaviour 13,14 or exhibiting other violent behaviour 2 .…”

Section: Introductionmentioning

confidence: 99%

Self-harm behaviour and externally-directed aggression in psychiatric outpatients: a multicentre, prospective study (viormed-2 study)

Scocco¹,

Macis

Ferrari

et al. 2019

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The aim of the project was to investigate differences between outpatients with Severe Mental Disorders (SMDs) with and without a history of Self-Harm behaviour (SHb) and/or Violent behaviour against other people (Vb) in relation to: (a) socio-demographic and clinical characteristics, (b) violent behaviour during a 1-year FU, (c) predictors of SHb and Vb during the FU. Outpatients with SMDs, with and without a history of Vb were enrolled. They were divided in four groups: patients with lifetime Vb (V), patients with both Vb and SHb (V-SH), patients with only SHb (SH) and patients with no history of SHb and Vb (control group, CONT). The frequency and severity of SHb and Vb during the FU were assessed every two weeks by the MOAS. Overall 246 patients were enrolled. BPRS-E Depression item, the SLOF Social acceptability, the BDHI Indirect Aggression, the BIS Motor Impulsiveness and the STAXI-2 Control-Out showed significant correlations with all the four groups (p < 0.030). V and V-SH patient groups reached higher scores in all MOAS sub-scales. Age among the SH group and BPRS-E affect-anxiety subscale among the V group significantly predicted aggression against people. In people with SMDs a history of SHb or Vb is associated with different medium-term outcomes.

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“…Several studies have investigated the presence of violent behaviors among inpatients of psychiatric wards. 21,24,[33][34][35][36][37][38] In contrast with a large amount of data reported for inpatients, studies with Italian 39,40 and international 41 outpatients are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…These results are similar to the results of recently conducted inpatient 34,36,46,47 and community studies. 39,48 One of our goals was to assess whether and how socioeconomic status can influence aggressive behaviors. To express patients' socioeconomic status, we used several variables, which are the most frequently analyzed in the literature: housing, level of schooling, and unemployment.…”

Section: Discussionmentioning

confidence: 99%

Aggressiveness and violence in psychiatric patients: a clinical or social paradigm?

et al. 2019

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ObjectivePsychiatric disorders are often considered the leading cause of violence. This may be due to a stereotype created by media and general opinion.MethodThe Modified Overt Aggression Scale (MOAS) was used to evaluate the severity of aggressive and violent behaviors in 400 patients who attended a post-acute psychiatric service in Milan from 2014 to 2016 and suffered from different psychiatric disorders. The psychopathological clinical picture was evaluated by Clinical Global Impression (CGI). The study also assessed the possible correlation between epidemiologic and sociodemographic factors, clinical variables, and aggression and violence.ResultsOf the total number of subjects, 21.50% showed a MOAS score >0, 11.50% presented mild aggression (0–10 MOAS weighted score), 9% moderate aggression (11–20), and 1% severe aggression (MOAS >20). With respect to violent behaviors, 16% of patients showed a score >0 in one MOAS subscale other than verbal aggression according to violence definition. The severity of clinical picture seemed to be related to higher weighted MOAS score. Multivariate testing of different sociodemographic and clinical variables showed that violence was related to unemployment status, and significantly correlated to compulsory admission (TSO), suicide attempts (TS), and personality disorders, while the severity of clinical psychiatric picture seemed to play a secondary role.ConclusionResults have shown that personality disorders and sociodemographic factors, including economic factors, seem to be major determinants of violence among patients diagnosed with mental disorders.

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Violence and mental disorders. A retrospective study of people in charge of a community mental health center

Cited by 22 publications

References 48 publications

Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy

Violence risk and mental disorders (VIORMED-2): A prospective multicenter study in Italy

Self-harm behaviour and externally-directed aggression in psychiatric outpatients: a multicentre, prospective study (viormed-2 study)

Aggressiveness and violence in psychiatric patients: a clinical or social paradigm?

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