Aggression of Chinese inpatients with schizophrenia: a systematic literature review

Abstract

To systematically review and analyze literature on episodes of aggression in psychiatric wards and to determine the coping and preventive strategies employed to deal with aggression of patients with schizophrenia. We used the key words such as "schizophrenia" and "aggression" to collect literature citations, which were published between July 1997 and November 2011, by searching databases such as the Chinese Journal Full-text Database (CJFD). The literature reports of aggression by patients with schizophrenia were surveyed by computer-assisted searches, scanning of reference lists, and manual search of relevant journals. We analyzed the reports of episodes of aggression in psychiatric wards. Prevalence of aggression in psychiatric wards was reported to range from 9.1% (95% CI: 6.3 to 11.9) to 49.6% (95% CI: 41.1 to 58.1), with most reports in the range of 20% to 40% (mean 28.0%). The aggressive behavior often occurred in special groups and typically bore a close relationship with the patient's personal qualities, social environment, or psychiatric symptoms. The aggressive behaviors can be attributed to a lack of standardized assessments and intervention instruments. There is a high risk of aggression in Chinese inpatients with schizophrenia, and it is urgent to establish the scientific, standardized, operational systems for assessing and treating the aggression of these patients.