Psychiatric Inpatient Population Research Articles

The relational institution: an ethnographic study of recovery orientation and relational engagement on a psychiatric rehabilitation ward in London

BackgroundIn the UK, inpatient psychiatric rehabilitation services for complex psychosis aim to provide recovery-orientated treatment to patients, with the goal of supporting sustained stepdown into community living. The extent to which rehabilitation services uphold this recovery orientation is associated with better outcomes. However, few studies have been able to ascertain what promotes or prevents recovery orientation in inpatient settings.MethodsWe conducted an ethnographic study of treatment on a National Health Service (NHS) psychiatric rehabilitation ward in London over six months during August 2022-February 2023. Data were collected through participant observation and semi-structured interviews with 9 patients and 14 staff members. Fieldnotes and interview transcripts were analysed using situational analysis.ResultsOur analysis highlights the importance of what we term ‘relational engagement’ between staff and patients to nurture and sustain recovery-orientated treatment. This relational engagement was embodied through small acts of genuine human connection grounded in mutual acceptance and affective bonding; close attention to detail that communicated curiosity and respect; and recognition, appreciation, and encouragement of the slow and gradual progress that characterises recovery in complex psychosis. Yet, this relational engagement was often limited or foreclosed by the social environment of the ward and the wider institutional context. Limiting elements included the dominance of hospital logics geared towards high-throughput acute treatment and risk management; the presence of audit culture that led to a level of standardisation curtailing more genuine human connection; and staff demoralisation driven by events on and off the ward, including system-wide crises and more localised conflicts and disturbances. Some of these conflicts involved discrimination, most prominently anti-Black racism and homophobia, reflecting wider structural inequalities that characterise inpatient psychiatric populations and the healthcare workforce.ConclusionRelationships, often under-prioritised in mental health services, were a key cornerstone of recovery-orientated treatment on a psychiatric rehabilitation ward. The shaping of therapeutic relationships amounted to an active process of relational engagement, which may be afforded or constrained by complex social elements requiring careful consideration in inpatient psychiatry. These social elements go beyond more surface-level factors such as staff training, knowledge, or attitudes and may require structural and system-level interventions.

Medical Chart Review to Explore Suicidal and Self-Harm Thoughts and Behavior Among Psychiatric Inpatients.

Suicide and self-harm events are elevated in psychiatric inpatient populations. In this study, health data were retrospectively collected from the medical records of 183 patients (97 civil and 86 forensic) who had resided in, or been admitted to, a public psychiatric hospital in Saskatchewan, Canada from April 1 to December 31, 2021. Descriptive and inferential analyses were conducted to estimate prevalence and correlates of (non-fatal) suicide and self-harm events, including recent and lifetime occurrences, according to patients' health information. Nearly two-thirds (62%) of patients had any record of non-fatal suicide or self-harm events, including a lifetime history of self-harm (42%) and suicidal behavior (37%) as well as recent self-harm (24%) and suicidal (31%) thoughts or behaviors. Forensic patients were significantly more likely to have a record of suicide and self-harm events. This study emphasizes the need for further research into the course of suicidality and self-harm in psychiatric inpatients.

Proposing a more conservative Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index cutoff score for forensic inpatient populations.

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) may be unreliable at its standard recommended cutoff score when used with forensic psychiatric inpatient populations given high rates of genuine cognitive impairment. The present study sought to (a) examine the rate of invalid performance on the RBANS EI using the standard cutoff among incompetent to stand trial (IST) inpatients and (b) investigate the psychometric properties of the RBANS EI at various cutoff scores. This study was conducted using archival assessment data collected at a large forensic psychiatric hospital. Across the entire sample (N = 238, 79% male, Mage = 45 years, 24% primary Spanish-speaking), 79% were diagnosed with a schizophrenia spectrum disorder. Experiment 1 of the study (n = 165) contained IST patients who were classified as having a valid presentation. Experiment 2 contained a valid (n = 46) and invalid (n = 27) presentation group comprised of postadjudication and IST inpatients, respectively. In Experiment 1, over one third (36.4%) of the valid presentation sample scored above the standard recommended EI cutoff. In Experiment 2, applying the standard recommended cutoff score of > 3 was associated with a false positive rate of over 20%. Obtaining < 10% false positive errors was achieved at a cutoff score of > 5. At this cutoff score, the estimated local base rate of invalid responding among IST patients was 28%. Clinical and forensic implications and recommendations for adopting this more conservative RBANS EI cutoff score are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

140. Assessing the Relationship Between BPD and Psychosis Among Psychiatric Inpatient Populations Using Self-Report Measures

140. Assessing the Relationship Between BPD and Psychosis Among Psychiatric Inpatient Populations Using Self-Report Measures

Divergent Phenotypes, Actionable Genotypes, and Phenoconversion in a German Psychiatric Inpatient Population: Results from the FACT-PGx Study

Divergent Phenotypes, Actionable Genotypes, and Phenoconversion in a German Psychiatric Inpatient Population: Results from the FACT-PGx Study

Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns.

Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73d vs. 10.52±10.37d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.

Depression, anxiety, and poor well-being at discharge from psychiatric hospitals: prevalence and risk factors.

Being ready for discharge is vital to successful hospital-to-home transitions. For many patients, however, the transition from psychiatric hospital care to outpatient care can be challenging. An in-depth understanding of the mental health conditions of patients at discharge is crucial and instructive for recovery research. The purpose of this study was to determine the prevalence and risk factors of depression, anxiety, and poor well-being symptoms among patients who are about to be discharged from psychiatric units in Alberta, Canada. Our aim was to help determine the prevalence of anxiety, depression, and overall well-being among the general psychiatric inpatient population in Alberta before discharge and the potential factors which may influence this. This epidemiological study used a cross-sectional quantitative survey from March 8, 2022, to November 5, 2023, to assess depression, anxiety, and well-being. Participants were invited to complete an online questionnaire that contained demographics, clinical information, and responses to the PHQ-9, GAD-7, and WHO-5 questionnaires. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed. The study found that the prevalence of likely depression, anxiety, and poor well-being among patients about to be discharged was 37.1%, 56.4%, and 48.3%, respectively. Based on a logistic regression model, there was a statistically significant association between anxiety, depression, and poor well-being diagnoses and multiple socio-demographic and clinical factors such as ethnicity, primary mental health diagnoses, education level, housing status, depression, anxiety, and well-being at baseline. Mental health assessment at discharge is a critical step in the recovery and transition of care. There is still a need for further research to identify the underlying causes and robust predictors of mental health symptoms in patients about to be discharged and to provide appropriate interventions and supportive resources both before and following discharge. Future research utilizing these findings may help identify key opportunities to improve outcomes for patients after discharge.

Predictors and Correlates of Positive Urine Drug Screening in a Retrospective Cohort Analysis of Child and Adolescent Psychiatry Inpatients Throughout the COVID-19 Pandemic.

Youth substance use is associated with significant psychological, neurological, and medical complications. Risk factors for substance use among children and adolescents in the general population include peer and/or parental substance use, certain psychiatric illnesses (eg, Attention-Deficit/Hyperactivity Disorder, depression), and history of maltreatment. Co-occurring substance use and psychiatric illness have been associated with increased suicidality, but few prior studies have characterized substance use among child/adolescent inpatients. As such, it remains unclear how substance use contributing to acute psychiatric presentations has changed since the start of the COVID-19 pandemic. This is a retrospective cohort study of 816 unique child/adolescent psychiatry inpatients with urine drug screening (UDS) results from a diverse urban setting. Charts of patients hospitalized between June 1, 2018 and November 30, 2021 were reviewed for sociodemographic characteristics, indication for admission, psychiatric history, hospital course, treatment plan, and discharge diagnosis. Differences in sociodemographic and clinical characteristics, such as age, race, and diagnoses, between patients with and without positive UDS were explored throughout various periods of the COVID-19 pandemic. Descriptive and comparative statistics were performed, as well as a logistic regression model to identify the predictors of positive UDS. Of the study sample, 18% had a positive UDS. Older age, diagnosis of impulsive or behavioral disorder, and a history of violence were found to be predictors of positive UDS. Asian/South Asian or Hispanic/LatinX race and history of a developmental or intellectual disability were found to be negative predictors. The frequency of positive UDS in this population did not change based on COVID-19. Multiple factors may predispose children and adolescents to substance use. Though no impact of COVID-19 was found in this sample, longer-term studies are needed. This study identifies independent predictors of active substance use in the child and adolescent psychiatric inpatient population.

Psychiatric disorders in inpatient Ethiopian migrant workers in the United Arab Emirates.

Migrant workers have higher rates of mental health problems than non-migrant workers, with Ethiopian migrant workers in the United Arab Emirates appearing to be overrepresented in the psychiatric inpatient population compared with their numbers in the general population. We sought to investigate the pattern of psychiatric inpatient admissions in Ethiopian migrant workers over a 10-year period (2011-2020) in order to highlight demographic and clinical characteristics, and to investigate factors predicting the length of hospital stay. We reported the mean and frequency of demographic and clinical data of Ethiopian psychiatric inpatients at one of the largest governmental hospitals in eastern Abu Dhabi between 2011 and 2020, and investigated factors predicting length of stay in hospital using linear regression. Our results show that Ethiopian expatriates made up 7.9% of all admissions over a 10-year period, had a mean length of hospital stay of almost 20 days, with 98.1% of them being female, 92.8% being domestic workers, 90.1% having a language barrier, 57.4% being single and 55.5.% having one or more recent stressors prior to admission. The most common diagnoses were acute stress reaction (31.6%), psychosis (29.3%), bipolar disorder (14.8%) and adjustment disorder (11.0%). Work-related stress, termination of employment and several clinical factors significantly predicted length of stay in hospital.

Psychiatric inpatient services in Ontario, 2019-2021: a cross-sectional comparison of admissions, diagnoses and acuity during the COVID-19 prerestriction, restriction and postrestriction periods.

The COVID-19 pandemic was associated with increased mental health problems in the general population, yet psychiatric hospital admissions decreased. Early evidence suggested that psychiatric admissions normalized within weeks; we sought to examine the longer-lasting impacts on the psychiatric inpatient population beyond this initial period. We compared Ontario Mental Health Reporting System admission data for patients admitted to 8 psychiatric hospitals in Ontario, Canada, between 3 time periods - before restrictions were imposed (June 22, 2019, to Mar. 16, 2020), during restrictions (Mar. 17 to June 21, 2020) and after restrictions were lifted (June 22, 2020, to Mar. 16, 2021) for changes in involuntary status, diagnoses and clinical presentation using descriptive analysis. For clinical presentation, we extracted scores on 4 Resident Assessment Instrument-Mental Health symptom scales (Depressive Severity Index, Cognitive Performance Scale, Positive Symptoms Scale-Long Version and Social Withdrawal Scale), and 2 behaviour scales (Aggressive Behavior Scale and Violence Sum). A cross-sectional sample of 9848 patients was included in the analysis. The mean number of daily admissions decreased 19% from 16.4 (standard deviation [SD] 8.0) before the restriction period to 13.3 (SD 6.1) during the restriction period, and was still 6% below prerestriction levels after restrictions were lifted 15.4 (SD 6.8), with standard error difference of 1.03 (95% confidence interval -0.22 to 2.29). From the pre- to the postrestriction periods, the proportion of involuntary patients increased by 6 percentage points, and the proportions of patients diagnosed with a psychotic disorder or personality disorder increased by 4 percentage points and 1 percentage point, respectively. Psychiatric admissions did not fully return to prerestriction levels in absolute rates and patient acuity after COVID-19 restrictions were lifted. Psychiatric services must prepare to appraise and respond to any increased acuity through interventions for patients, workforce planning and mental health support for staff.

Widening the Net: Adapting a Dialectical Behavior Therapy Skills–Informed Group Intervention to Better Meet the Needs of an Urban-Poor Psychiatric Psychiatric Inpatient Population

Abstract: This article details various considerations in the development of a dialectical behavior therapy skills–informed weekly group intervention for psychiatric inpatients receiving treatment in an economically disadvantaged city safety-net hospital. The authors describe the impact of multiple compounding stressors, such as poverty, racial and ethnic discrimination, housing/food insecurity, complex trauma, education level, and other psychological and psychosocial stressors that informed the development of the intervention. Overarching goals of this intervention focused on treatment engagement, assurance that the intervention met best practices in trauma-informed care, and orienting treatment to focus on patient empowerment. Additionally, this article discusses the process of developing a group-based, DBT skills–informed intervention to be applicable to patients with diverse psychiatric diagnoses and varying levels of functioning on an inpatient unit. The benefits of this treatment approach as well as the considerations taken to adapt it to the multifactorial needs of the patient population are also discussed.

Sexual assault in the inpatient psychiatric setting

Sexual assault in the inpatient psychiatric setting is a significant problem with serious, lasting consequences. It is important for psychiatric providers to appreciate the nature and magnitude of this problem to be able to provide an appropriate response when faced with these challenging scenarios, as well as to advocate for the implementation of preventive measures. This article provides a review of the existing literature regarding sexual behavior in the inpatient psychiatric unit, describing the epidemiology of sexual assaults in these settings, and exploring the characteristics of both victims and perpetrators, with a particular focus on factors of relevance to the inpatient psychiatric patient population. Inappropriate sexual behavior in inpatient psychiatric settings is common, however the varying definition of such throughout the literature serves as a challenge to clearly identifying the frequency of specific behaviors. The existing literature does not identify a way to reliably predict which patients are most likely to engage in sexually inappropriate behaviors on an inpatient psychiatric unit. The medical, ethical, and legal challenges that such cases present are defined, followed by a review of current management and prevention strategies, and suggested future directions for research.

Impact of personality dysfunction on interdisciplinary treatment team working alliance in an inpatient psychiatric population.

Cluster B personality disorders (PDs) share specific traits that can result in interpersonal conflict. As therapeutic working alliance has a strong relationship with improved outcomes, there is interest in understanding the relationship between PDs, working alliance, and clinical outcomes. This is especially compelling in inpatient populations, where symptoms are severe, and patients are working with a treatment team. The aims of this study were to (a) assess whether higher team working alliance is associated with lower depressive symptoms, (b) assess whether patients with Cluster B PD traits have worse working alliance with their team than patients without those Cluster B PD traits, and (c) assess whether higher team working alliance is associated with lower depressive symptoms when Cluster B PD traits are present. Team working alliance was measured at baseline and at discharge for 3,406 inpatients at a psychiatric hospital. Improved team working alliance was associated with lower depression scores at discharge. Patients with borderline personality disorder traits had worse team working alliance, whereas patients with narcissistic personality disorder and antisocial personality disorder traits had similar working alliance scores as other patients. Borderline personality disorder and antisocial personality disorder traits moderated the association between team working alliance and depressive symptoms differently. Findings suggest that team working alliance works similarly to therapist working alliance. Of clinical importance is the finding that team working alliance and its relationship with depression symptoms differ based on Cluster B PD traits, and the importance of strong working alliance regardless of interpersonal challenges due to personality pathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cardiovascular risk estimation in rural psychiatric inpatient populations: Cross-sectional preliminary study.

Cardiovascular risk was evaluated in patients admitted to rural inpatient psychiatric services over a one-year period in a sparsely populated region of the United Kingdom. Care records were analysed for risk factor recording, and cardiovascular risk estimated using the QRISK3 calculator, which estimates 10-year risk of myocardial infarction or stroke. Of eligible patients, risk factor recording as part of routine care was completed in 86% of possible QRISK3 inputs, enabling QIRSK3 estimation in all eligible patients. QRISK3 for this group was significantly raised relative to an age, sex and ethnicity-matched population, and high risk of cardiovascular disease (QRISK3 score >10%) was detected in 28% of patients. The results demonstrate that there is significant unmet need in rural patients for cardiovascular risk reduction that could be identified as part of routine care. An opportunity exists to integrate mental and physical healthcare by routinely assessing cardiovascular risk in rural psychiatric inpatients. Resources and training are needed to produce this risk information and act on it.

Comparing psychiatric routine care and integrative psychiatry – A study protocol for a prospective observational study (INTEGRAL)

IntroductionIn recent years, complementary and alternative medicine therapies have been increasingly studied for their effectiveness, and there are more and more studies supporting the use of some practices in the psychiatric setting. Despite the high acceptability and interest of patients using a holistic approach to recover from mental health issues, complementary and alternative medicine therapies are not yet integrated in the conventional treatment. This study investigates the potential of an integrative psychiatry approach compared to treatment as usual in a heterogeneous inpatient population. MethodsINTEGRAL is an observational study comparing two psychiatric hospitals. In total 240 inpatients with a diagnosis of a mental disorder (substance use, schizophrenia, depression, anxiety, post-traumatic stress and somatoform disorder) will be included. One hospital offers standard therapy, the other one has established an integrative medicine approach combining conventional treatment with CAM. The integrative approach provides a non-standardized complex patient-centered mental health care. Outcomes will be assessed at three time points and focus on the following three frameworks: severity of disease, personal recovery and trans-diagnostic phenomena. DiscussionTo our knowledge and research, this study is the first prospective observational study comparing psychiatric routine care and integrative psychiatry and will give us a glimpse of the effects on severity of disorders, trans-diagnostic symptoms and recovery in different psychiatric inpatient populations in the short and long term. The study may help to optimize the treatment of patients suffering from severe mental illness in providing a patient-centered approach with a diversity of evidence-based practices.

Need for Treatment, A Less Restrictive Alternative to Hospitalization, and Treatment Provision: The Utility of Community Treatment Orders.

Provision of involuntary care is an abridgment of civil rights and a source of controversy. Its circumstances require continued monitoring. This study asks 4 questions: Whether, in an era, focused on allowing patients with capacity to refuse community-treatment-order (CTO)-assignments, CTO use decreased. And whether CTOs fulfilled 3 statute mandates: Were CTO-assigned patients in greater need of treatment than other psychiatric inpatients? Was CTO assignment a less-restrictive alternative to psychiatric hospitalization? and Did CTO assignment provide needed treatment at internationally recommended levels with consequences for patient outcomes? All 214 388 Victoria, Australia mental health admissions between 2000- 2017 were reviewed. Two cohort samples were drawn and followed through 2019-ie, all 7826 hospitalized patients who were first placed on CTOs from 2010 to 2017 and 13 896 hospitalized patients without CTO placement. Logistic Regression was used to specify determinants of CTO assignment from the psychiatric inpatient population. OLS Regression with propensity score control to evaluate study questions. In the 2010-2017 decade, initial CTO assignments decreased by 3.5%, and initial hospitalizations increased by 5.9% compared to the 2000-2009 period. At hospital admission and discharge, based on Health of the Nations Score ratings, the CTO-cohort's need for treatment exceeded that of non-CTO patients. CTO patients had 3.75 fewer days in average inpatient episode duration than other inpatients, when adjusted for CTO-assignment determinants, the ratio of patients to community case managers, and patient housing status. CTO patients needing rehospitalization spent 112.68 more days in the community than re-hospitalized non-CTO patients. Patient to case-manager ratios falling above recommended levels and the patient marginal housing status contributed to longer hospital stays and reduced community tenure. Victoria relied less on CTOs as an LRA, consequently, experiencing increased initial hospitalizations. CTO patients were in greater need of treatment than non-CTO patients, yet, with required oversite had shorter hospitalizations and more time out of hospital prior to rehospitalization than the less severely ill non-CTO group. Patient LRA outcomes were adversely affected by higher than recommended community patient to case-manager ratios limiting needed treatment provision to hospital.

COVID-19 infection at a psychiatric hospital in KwaZulu-Natal, South Africa: Clinical service planning and challenges.

South Africa had over 4 million cases of coronavirus disease 2019 (COVID-19) infections and more than 1 million COVID-19-related deaths. Despite the devastating psychological impact of the COVID-19 pandemic, there is little qualitative, critical evaluation of government mental health services in this resource-limited setting. The authors describe the clinical service plan and response to the COVID-19 pandemic at a government psychiatric hospital. KwaZulu-Natal, South Africa. A descriptive narrative overview of the specialised psychiatric hospital's clinical response (April 2020 - March 2021) to the COVID-19 pandemic was undertaken in the following domains: screening policy; testing and swabbing policy; staff training and monitoring; and restructuring the wards to accommodate mental health care users (MHCUs) with suspected cases of COVID-19. The in-depth narrative reviews led to the introduction of staff training, routine COVID-19 reverse transcription polymerase chain reaction (RT-PCR) testing of all MHCUs, the creation of designated quarantine and isolation facilities and screening of physical health status of patients with COVID-19 prior to transfer being implemented to prevent an outbreak or increased morbidity or mortality. Implementing a service plan early which included staff training, screening and routine COVID-19 testing services for psychiatric admissions in a rapidly evolving environment with few additional resources was challenging. The absence of guidelines early in the pandemic that addressed the unique needs of a clinical psychiatric inpatient population is a noteworthy learning point. The article highlights that the inpatient infrastructural requirements and clinical management protocols of acutely psychiatrically ill inpatients, in the context of infectious outbreaks, require dedicated task teams and bespoke policies.

Promoting Health Equity Through Voter Support Activities for the Inpatient Psychiatric Population.

Individuals with mental illness often face barriers to voting. One of the primary barriers is not being registered to vote. This paper describes voter support activities (VSAs) provided to hospitalized adults on the acute inpatient psychiatric units at Pennsylvania Psychiatric Institute. During the six weeks preceding the 2020 general election, adult inpatients were offered six VSAs and an optional survey examining previous voting behaviors and barriers encountered to voting. VSAs included checking voter registration status and polling location, completing a paper or electronic voter registration application, and requesting a mail-in ballot. Of 189 patients approached, 119 individuals participated in the survey and 60 individuals utilized at least one VSA. This project demonstrates that VSAs are a welcome and feasible resource for psychiatrically hospitalized adults. Psychiatric providers can serve an important role in promoting access to voting-related activities for their patients.

High-sensitivity C-reactive protein is related to age and gender in an acute psychiatric inpatient population

Increased levels of high-sensitivity C-reactive protein (hsCRP) is associated with several psychiatric disorders. Demographic factors such as age and gender might affect this association, but the results are conflicting. The aim of this study was to explore a relationship between age, gender and hsCRP in an acute psychiatric inpatient population. We included 484 patients admitted to an acute psychiatric ward. Based on age distribution percentiles (25%, 50% and 75 %), we categorized patients into three age groups; ≦31 years old, 31–47 years old and ≧ 48 years old. Differences in serum levels of hsCRP between the age groups were assessed in the total sample, within males and females, and within diagnostic groups. There were significant differences in hsCRP across age groups. The effect was stronger in males than females. The significant differences between age groups were kept among patients with substance use disorders and bipolar disorders, but not among schizophrenia spectrum disorders, unipolar depression, neurotic disorders and personality disorders. Our findings suggest that the previously known association between age and hsCRP is present within an acute psychiatric population. However, this association was not found for all psychiatric diagnoses.

Prevalence and correlates of aggressive behavior in psychiatric inpatient populations.

Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest. One reason for this is that psychiatric patients are generally considered more likely to be aggressive, which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior. Predicting aggression in psychiatric wards is crucial, because aggressive behavior not only endangers the safety of both patients and staff, but it also extends the hospitalization times. Predictions of aggressive behavior also need careful attention to ensure effective treatment planning. This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes (dementia, psychoactive substance use, acute psychotic disorder, schizophrenia, bipolar affective disorder, major depressive disorder, obsessive-compulsive disorder, personality disorders and intellectual disability). The prevalence of aggressive behavior and its underlying risk factors, such as sex, age, comorbid psychiatric disorders, socioeconomic status, and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior. Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed. Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.