TY - JOUR
T1 - Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence
AU - de Girolamo, Giovanni
AU - Buizza, Chiara
AU - Sisti, Davide
AU - Ferrari, Clarissa
AU - Bulgari, Viola
AU - Iozzino, Laura
AU - Boero, Maria Elena
AU - Cristiano, Giuseppe
AU - De Francesco, Alessandra
AU - Giobbio, Gian Marco
AU - Maggi, Paolo
AU - Rossi, Giuseppe
AU - Segalini, Beatrice
AU - Candini, Valentina
AU - Andreose, Suor
AU - Basso, Pasquale
AU - Beneduce, Rossella
AU - Bertolotti, Pietro
AU - Braida, Vanda
AU - Bonelli, Marina
AU - Bongiorno, Fanny
AU - Bussi, Riccardo
AU - Castagno, Elisa
AU - Dominicis, Fabio
AU - Ghersi, Loredana
AU - Greppo, Stefania
AU - Sodano, Alessandro Jaretti
AU - Leporatti, Massimo
AU - Presti, Eleonora Lo
AU - Milone, Valeria
AU - Panigada, Fausto
AU - Pasquadibisceglie, Livia
AU - Rigamonti, Danilo
AU - Rillosi, Luciana
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background: Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. Aims: To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. Methods: In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. Results: The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. Conclusions: Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.
AB - Background: Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. Aims: To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. Methods: In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. Results: The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. Conclusions: Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.
KW - Mental disorders
KW - Recidivism
KW - Residential facilities
KW - Violence
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U2 - 10.1016/j.jpsychires.2016.05.010
DO - 10.1016/j.jpsychires.2016.05.010
M3 - Article
AN - SCOPUS:84971238079
VL - 80
SP - 5
EP - 13
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
SN - 0022-3956
ER -