Abstract
Violent behavior in correctional facilities is common and differs substantially in type, target, implication, and trigger. Research on frequency and characteristics of violent behavior in correctional facilities and psychiatric hospitals is limited. Results from recent research suggest that comorbidity of severe mental disorder, personality disorder, and diagnosis of substance abuse is related to a higher risk of violent behavior. In the Berlin prison hospital, a database was created to collect data from all violent incidences (n=210) between 1997 and 2006 and between 2010 and 2016. In a retrospective, case-control study, we analyzed specific socioeconomic data and psychiatric diagnosis and compared the group of prisoners with violent behavior with randomly selected prisoners of the same department without violent behavior (n = 210). Diagnosis of schizophrenia, non-German nationality, no use of an interpreter, no children, and no previous sentence remained significantly associated with the dependent variable violent behavior. There were no significant differences regarding age and legal statuses. Practical implications for clinical work are discussed.
Highlights
Violent behavior is a complex phenomenon linked to biological, psychological, and social factors [1], and it constitutes a common problem in mental health care settings, as well as in correctional facilities
The univariate analysis of variables associated with violent behavior demonstrated statistically significant results for the items age, previous sentences, nationality, use of an interpreter, children, and diagnosis of a mental disorder
Our results present a rate for patients that demonstrated violent behavior in a prison hospital that ranged from 3.2 to 15.9%
Summary
Violent behavior is a complex phenomenon linked to biological, psychological, and social factors [1], and it constitutes a common problem in mental health care settings, as well as in correctional facilities. Regarding facilities of community-based mental health care, violent behavior was reported in about 2–7% of all admissions in psychiatric hospitals in Germany [2, 3]. Müller et al reported a moderate increase in violent behavior against staff members in psychiatric inpatient settings between 2008 and 2015, with an average increase in violent incidences of 4% per year [4]. A recent metaanalysis, including 23.972 hospitalized psychiatric patients, reported that 17% had at least once acted violently during their hospital stay [5]. Staggs et al described no changes from 2007 to 2013 regarding the frequency of violent assaults in U.S American psychiatric wards [6], but reports from other countries are lacking
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