Detection of Impending Aggressive Outbursts in Patients with Psychiatric Disorders: Violence Clues from Dogs

Uriel Bakeman,Dan Grinstein,Clara Moray Schild,Hodaya Eilam,Yuval Eshed,Morris Laster,Sharon Anavi-Goffer,Ester Fride

doi:10.1038/s41598-019-52940-w

Uriel Bakeman, Dan Grinstein + Show 6 more

Open Access

https://doi.org/10.1038/s41598-019-52940-w

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Abstract

Aggression in psychiatric wards is a continuing matter of concern for both patients and medical staff. Here we have tested the hypothesis that the frequency of such incidents can be reduced with a new strategy of using trained alert dogs that warn of impending violent outbursts. Dogs were positioned among patients in psychiatric wards. Analyses show that the dogs warned of impending aggressive outbursts, responding to signals from a specific patient out of a group of unfamiliar psychotic patients. Their alerts were not a response to stress as canine cortisol levels were not significantly changed. Visual glance was the preferred method used by young dogs to respond to patient. Until a similar electronic technology is developed, trained alert dogs can help caregivers to protect both the patient and those around them from injuries that may otherwise result from aggressive outbursts in psychiatric patients.

Highlights

In this study we hypothesised that specially trained dogs can warn of violent outbursts of inpatients in psychiatric wards
The Chi square statistic indices for predictive accuracy demonstrated that out of 30 patients, who potentially could each have at least one violent outburst per day, 85% were positively alerted (Sensitivity, 95% confidence interval (CI) 74.0–92.5%), while 99.6% of the patients who did not express violent outbursts were not alerted (Specificity, 95% CI 99.2–99.8%), predicting that 86% of the alerts will be followed by true outbursts (Positive Predictive Value, 95% CI 75.3–93.5%), leaving 14% cases as false-positive alerts, the Likelihood ratio was 208.8
By correlation with the information from the hospital, we discovered that in the nearby wards there were cases of violence near to the time of the dog alert. These results suggest that a proportion of these ‘unfocused alerts’ were ‘true positive’ impending violent outbursts, which were identified by the dogs www.nature.com/scientificreports

Summary

Introduction

In this study we hypothesised that specially trained dogs can warn of violent outbursts of inpatients in psychiatric wards. This hypothesis is based on the integration of current knowledge from several reports including reports on the ability of pet dogs to anticipate physiological changes in patients[4,8,9,10,12,18,19] or changes in human mood[6], as well as on reports of other diseases (reviewed by20) that dogs can detect volatile compounds from the breath of patients with schizophrenia[21], from stools/urine of patients with cancer[17,22] and from other parts of the body. The alerts might be influenced by the close attachment between the owner and the dog[23]

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