Predictors of aggressive behavior among acute psychiatric patients: 5 years clinical study

2016 ◽  
Vol 33 (S1) ◽  
pp. S626-S627
Author(s):  
T. Aparicio Reinoso ◽  
S. Gonzalez Parra
Keyword(s):  
Psychiatric Patients ◽  
Therapeutic Option ◽  
Violent Behavior ◽  
Nursing Assistants ◽  
Psychotic Symptoms ◽  
Admission Diagnosis ◽  
Psychiatric Ward ◽  
Competing Interest ◽  
In The Beginning

IntroductionThe problem of violence and aggressive behaviour among patients with psychiatric disorders need careful assessment to improve the quality of psychiatric care.ObjectiveThe aim of this paper is to describe the characteristics of repeated episodes of violence among patients admitted to a Psychiatric Ward, which is a total of 66 beds at Doctor Rodriguez Lafora Hospital from January 2009 to December 2014.MethodsWe designed a retrospective, longitudinal and observational study over a 5-year period in two brief hospitalization units of Doctor Rodriguez Lafora Hospital in Madrid. The main variables studied were: type of admission, diagnosis, age, trigger and shift.ResultsIn our study, we analyzed the prototypical person who carries out these episodes of aggression: a male between 31–40 years, diagnosed with psychotic disorder or personality disorder, involuntary admitted. This episode is associated as a main trigger to mood disturbances, lack of acceptance of standards and psychotic symptoms. These episodes occur more frequently in the afternoon shift one business day and often processed without injuries or minor bruises to other patients and/or nursing assistants. In our practice, we have observed that in most cases adequate verbal restraint in the beginning is sufficient to prevent the episode of aggression.ConclusionsUnderstand the aggressive factors can influence the production of violent behavior and the use of appropriate containment techniques may be considered a therapeutic option to prevent and address violent behavior in psychiatric patients hospitalized in brief hospitalization units.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Symptom Profile of Psychiatric Patients With Psychosis or Psychotic Mood Disorder in Prison

2018 ◽  
Vol 62 (13) ◽  
pp. 4158-4173 ◽  
Author(s):  
J. van Beek ◽  
P. J. Vuijk ◽  
J. M. Harte ◽  
E. J. A. Scherder
Keyword(s):  
Negative Symptoms ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Violent Behavior ◽  
Psychotic Symptoms ◽  
Psychiatric Ward ◽  
Symptom Profile ◽  
Patient Groups ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

There is evidence that psychiatric patients with psychotic or manic disorders who are incarcerated suffer from the same symptoms as psychiatric patients who are treated in the community. There are also indications that their symptoms might be more severe. The aim of this study was to examine the severity of psychotic and manic symptoms, as well as to collect information about the emotional functioning of patients admitted to a prison psychiatric ward. Incarcerated patients with a diagnosis of psychotic or a manic disorder were examined with the Brief Psychiatric Rating Scale–Expanded (BPRS-E). With the scores of 140 assessments, a symptom profile was created using the domains of the BPRS-E. This profile was compared with the clinical profile of three nonincarcerated patient groups described in literature with a diagnosis in the same spectrum. We found high scores on positive and manic psychotic symptoms and hostility, and low scores on guilt, depression, and negative symptoms. High scores on manic and psychotic symptoms are often accompanied by violent behavior. Low scores on guilt, depression, and negative symptoms could be indicative of externalizing coping skills. These characteristics could complicate treatment in the community and warrant further research along with clinical consideration.

The role of psychosocial treatment in decreasing of future violence behavior risk in forensicly treated psychiatric patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 783-783
Author(s):  
S. Jonovska ◽  
V.Š. Jengić ◽  
L. Safner ◽  
G. Bošković ◽  
S. Zudenigo
Keyword(s):  
Psychiatric Patients ◽  
Violent Behavior ◽  
Psychosocial Treatment ◽  
Violence Risk ◽  
Forensic Psychiatric Patients ◽  
Forensic Treatment ◽  
Aggression Questionnaire ◽  
Schizophrenic Group ◽  
Forensic Psychiatric ◽  
In The Beginning

The main aim of this study was to establish to what extent psychosocial treatment as a part of complex, multicomponent forensic treatment has an influence on decreasing of the future violence behavior risk in population of forensic psychiatric patients. We examinated 13 patients treated on Department of Forensic Psychiatry of Psychiatric Hospital Rab in Rab, Croatia. 9 of them were males and 4 of them females, 25–60 years of age, all of them were compulsory hospitalized because of committed criminal act connected with violent behavior. All of them have diagnosis of schizophrenic group of diseases with different duration of forensic treatment (from few months to few years). During 2010. all of them participated in psychosocial programe workshops once a week, for 6 months.MethodsViolence Risk Screening-10 (V-RISK-10), subjective measure of the programme chairmen performed in the beginning and in the end of the programme. The Aggression Questionnaire and Daily Spiritual Experience Scale as self-assesment scales were performed in the end of the programme. Results point on decreasing of V-RISK-10 results in the end of the programe in all participants. Interested observation was that mentioned results and those on self-assesment scales were not always been correlated positively. We also proved negative correlation between aggressivity and spirituality. As a conclusion, we have indications to believe that is real to expect that comining psychosocial treatment with targeted psuchopharmacological interventions could leed to decreasing the risk of future violent bihevior in forensicly treated psuchiatric patients.

Experimental intervention program in psychosomatic pathology

2017 ◽  
Vol 41 (S1) ◽  
pp. S490-S490
Author(s):  
A. Coutinho ◽  
D. Silva ◽  
I. Carvalho ◽  
R. Ribeiro Silva ◽  
L. Ribeiro
Keyword(s):  
Intervention Program ◽  
Human Organism ◽  
Relaxation Techniques ◽  
Psychosomatic Illness ◽  
Psychosomatic Disease ◽  
Competing Interest ◽  
Expression Of Emotions ◽  
In The Beginning ◽  
Psychosomatic Diseases

IntroductionThe work of Bion, developing the psychoanalytic theories of Freud and Klein on the origins of anxiety in childhood, includes the hypothesis of a protomental system as a matrix in the human organism in which physical and mental are at first undifferentiated. He defends that the continuing experience by the infant of parental containment of its anxieties, through a process of projection and introjection, develops its capacity for thinking about frustration rather than evading it. This conception was extended to psychosomatic illness, by the hypothesis that, without this experience, frustration may lead to basic assumption mentality and psychosomatic illness rather than emotions and thought.ObjectivesThis work aims to describe an experimental technique of group psychotherapy, inspired in Bion's principles combined with relaxation techniques, in the context of psychosomatic diseases.AimsThe authors pretend to identify improvement in clinical symptomatology, quality of life, identification and expression of emotions, in the group submitted to this method, compared to controls.MethodsIt was performed a weekly group psychotherapeutic session and a weekly relaxation session (using Jacobson's method), along two months. The patients were randomly selected and submitted to psychological evaluation with scales and questionnaires, in the beginning and at the end of the study.ResultsAt the time of submission of this work, the results of the intervention were in analysis.ConclusionsThis paper describes an experimental method of psychotherapeutic intervention in the field of psychosomatic disease, using a transdisciplinary perspective.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevalence and predictors of metabolic syndrome in a sample of Italian psychiatric inpatients

2017 ◽  
Vol 41 (S1) ◽  
pp. S472-S472
Author(s):  
L. Fusar-Poli ◽  
N. Brondino ◽  
M. Rocchetti ◽  
M. Ballerio ◽  
M. Vercesi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Medical Records ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Roc Curves ◽  
Psychiatric Ward ◽  
Psychotropic Agents ◽  
Unhealthy Diet ◽  
Common Risk Factors ◽  
Competing Interest

IntroductionPsychiatric population is characterized by a higher prevalence of cardiovascular events compared to general population. This difference might be due, in part, to the metabolic adverse effects of psychotropic agents, and, in part, to common risk factors such as smoking, sedentary lifestyle and unhealthy diet. Another potential risk factor is represented by the presence of metabolic syndrome (MetS).ObjectivesWe aimed to evaluate the prevalence of MetS and to identify the baseline predictors for the longitudinal development of MetS in a sample of Italian psychiatric inpatients.MethodsMedical records of 343 patients admitted to our psychiatric ward between 2007 and 2012 were retrospectively reviewed.ResultsPrevalence of MetS was 21.5%. MetS appeared directly associated with age and number of medication assumed. ROC curves showed HDL as the best predictor of metabolic syndrome in our sample.ConclusionsOur results confirm previous data on the association between metabolic syndrome and exposure to complex polytherapy. Additionally, our findings support the notion of psychiatric patients as an at-risk group for metabolic abnormalities, which should be carefully monitored.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Anti-psychotics: To withdraw or not to withdraw?

2017 ◽  
Vol 41 (S1) ◽  
pp. S752-S752
Author(s):  
C. Ferreira ◽  
S. Alves ◽  
C. Oliveira ◽  
M.J. Avelino
Keyword(s):  
Side Effects ◽  
Scientific Literature ◽  
Psychiatric Patients ◽  
Careful Consideration ◽  
Online Searching ◽  
Cardiac Side Effects ◽  
Scientific Papers ◽  
Competing Interest ◽  
Few Data

IntroductionAnti-psychotics constitute a class of psychotropic drugs used for the treatment and prophylaxis of several disorders, including schizophrenia, bipolar disorder and psychotic depression. Frequently, clinicians are asked by their patients to withdraw this medication. In some cases, that may be related to notable side effects. However, it may actually indicate an inadequate control of the psychiatric disorder with poor insight.AimsThe goal of this work is to systematically review the scientific literature in order to understand if there are consistent data that support anti-psychotics withdraw in specific clinical situations.MethodsThe literature was reviewed by online searching using PubMed®. The authors selected scientific papers with the words “anti-psychotics” and “withdraw” in the title and/or abstract, published in English.Results and discussionAnti-psychotics improve prognosis and enhance patients’ quality of life. There are few data in the literature regarding recommendations that support anti-psychotic withdraw in psychiatric patients. Very specific conditions must exist for withdrawing anti-psychotics, like neuroleptic malignant syndrome, cardiac side effects, and change of diagnosis or prolonged remission after a first and single psychotic event. When that decision is made, it should be done slowly and carefully and both the patient and his family should be involved.ConclusionsThere is no evidence in the literature that supports withdraw of anti-psychotics for the majority of psychiatric situations. When specific conditions are present that possibility must then be considered, however, with careful consideration and after discussion with the patient and parties involved in patient's care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Perceptual symptoms in the latino psychiatric patients attending inner city outpatient clinic

2016 ◽  
Vol 33 (S1) ◽  
pp. S401-S401
Author(s):  
L. Gonzalez ◽  
A. Khadivi ◽  
W. Gu ◽  
P. Korenis
Keyword(s):  
Psychiatric Patients ◽  
Cultural Beliefs ◽  
Significant Proportion ◽  
Psychotic Symptoms ◽  
Psychiatric Clinic ◽  
Latino Population ◽  
Psychotic Illness ◽  
Cultural Backgrounds ◽  
Retrospective Case ◽  
Competing Interest

IntroductionPsychotic symptoms occur in a variety of psychiatric disorders and medical conditions. In addition, a significant proportion of the general population reports history of psychotic symptoms in the apparent absence of a psychiatric disorder. Reviewed literature suggests that Latino patients report certain forms of visual and auditory hallucinations without other indications of psychotic illness. In addition, it is common that some individuals with diverse religious or cultural backgrounds may present with psychotic transient experiences, which can be culturally normative.ObjectiveTo determine the prevalence of hallucinations and describe the nature of hallucinatory experiences in relation to cultural belief in Latino and non-Latino psychiatric outpatients.MethodsWe conducted a retrospective case control study of 146 patients who were admitted to the outpatient psychiatric clinic for a period of ten months. We assessed clinical characteristics of these patients and reviewed the extended mental status examination, which contained questions about various form of hallucinations and spiritual experiences. This poster will explore the prevalence of hallucinations in the Latino population and determine the percentage of patients with a diagnosis of psychotic illness. A discussion of the phenomenological hallucinatory experiences and its relationship to cultural beliefs in the Latino psychiatric patients will also be presented.ConclusionsPsychotic symptoms present differently across cultures. The Latino population is most likely to have psychotic like symptoms related to their cultural beliefs. Clinicians must understand the diverse cultural experiences and beliefs of the patients they work with to prevent misdiagnosis of culturally normative experiences.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attitudes toward psychiatry and psychiatric patients in medical students: Can real-world experiences reduce stigma?

2016 ◽  
Vol 33 (S1) ◽  
pp. s218-s218 ◽  
Author(s):  
M. Pascucci ◽  
E. Stella ◽  
M. La Montagna ◽  
A. De Angelis ◽  
P. Parente ◽  
...  
Keyword(s):  
Mental Illness ◽  
Medical Students ◽  
Psychiatric Patient ◽  
Real World ◽  
Psychiatric Patients ◽  
Statistical Significance ◽  
Premature Death ◽  
Psychiatric Ward ◽  
Increased Risk ◽  
Competing Interest

IntroductionStigma towards psychiatry and mental illness significantly worsens the quality of life of psychiatric patients. Negative prejudices in medical students make it difficult for future doctors to send patients to mental health services and promote an increased risk of premature death.AimsOur aim is to assess stigma towards mental illness and psychiatry in medical students, and to study the influence of real-world experiences, such as having visited a psychiatric ward, having personally met a psychiatric patient or having friends and/or family members who suffer from a mental illness.MethodsOne hundred and thirteen Italian medical students completed the following tests:– Attitudes Towards Psychiatry (ATP-30);– Community Attitudes Towards Mental Ill (CAMI);– Perceived Discrimination Devaluation Scale (PDD);– Baron-Cohen's Empathy Quotient (EQ).ResultsHaving visited a psychiatric ward correlates with a better attitude towards psychiatry (P = 0.008), rather than towards the mentally ill. Having personally known someone with mental disorders correlates with less stigmatizing scores in CAMI: total score (P = 0.002), authoritarianism (P < 0.001), benevolence (P = 0.047) and social restriction (P = 0.001). Similar results emerged in those who have close relationships with a psychiatric patient. There is no statistical significance as to empathy.ConclusionsThe students who have visited a psychiatric ward have a less stigmatizing vision of psychiatry, while having personally known psychiatric patients favors a less stigmatizing attitude towards them. Those who have not had this experience, have a more hostile and intolerant vision of mental illness, and consider psychiatric patients as inferior subjects that require coercive attitudes and that would be better to avoid because socially dangerous.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The use of Polygenic Risk Scores to Inform Aetiology of Mood and Psychotic Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S166-S166
Author(s):  
J. Harrison ◽  
S. Mistry
Keyword(s):  
Bipolar Disorder ◽  
Genetic Basis ◽  
Psychotic Disorders ◽  
Mental Illnesses ◽  
Risk Scores ◽  
Psychotic Symptoms ◽  
Polygenic Risk ◽  
Genetic Overlap ◽  
Competing Interest

IntroductionPolygenic risk scores (PRS) incorporate many small genetic markers that are associated with conditions. This technique was first used to investigate mental illnesses in 2009. Since then, it has been widely used.ObjectivesWe wanted to explore how PRS have been used to the study the aetiology of psychosis, schizophrenia, bipolar disorder and depression.AimsWe aimed to conduct a systematic review, identifying studies that have examined associations between PRS for bipolar disorder, schizophrenia/psychosis and depression and psychopathology-related outcome measures.MethodsWe searched EMBASE, Medline and PsychInfo from 06/08/2009 to 14/03/2016. We hand-searched the reference lists of related papers.ResultsAfter removing duplicates, the search yielded 1043 publications. When irrelevant articles were excluded, 33 articles remained. We found 24 studies using schizophrenia PRS, three using bipolar PRS and nine using depression PRS. Many studies successfully used PRS to predict case/control status. Some studies showed associations between PRS and diagnostic sub-categories. A range of clinical phenotypes and symptoms has been explored. For example, specific PRS are associated with cognitive performance in schizophrenia, psychotic symptoms in bipolar disorder, and frequency of episodes of depression. PRS have also demonstrated genetic overlap between mental illnesses. It was difficult to assess the quality of some studies as not all reported sufficient methodological detail.ConclusionsPRS have enabled us to explore the polygenic architecture of mental illness and demonstrate a genetic basis for some observed features. However, they have yet to give insights into the biology, which underpin mental illnesses.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Parkinson Psychosis: A Complex Interaction of Disease and Medication Related Factors

2017 ◽  
Vol 41 (S1) ◽  
pp. S662-S662
Author(s):  
S. Petrykiv ◽  
L. de Jonge ◽  
M. Arts
Keyword(s):  
English Language ◽  
Case Reports ◽  
Pharmacological Therapy ◽  
Complex Interaction ◽  
Psychotic Symptoms ◽  
Psychiatric Ward ◽  
Related Factors ◽  
Appropriate Therapy ◽  
Competing Interest ◽  
Paranoid Psychosis

IntroductionPsychotic symptoms are the most important non-motoric symptoms of the Parkinson disease (PD). The quality of life of those patients can be significantly improved with an appropriate therapy. In this article we provide evidence about the etiology, differential diagnosis and therapeutic possibilities with a work-up for the clinics.Objectives & aimsTo provide a case report of patient with PD who developed a paranoid psychosis after administration of levodopa/carbidopa, followed by a literature review on psychotic symptoms evoked by psychotropic medication by patients with PD.MethodsAn English-language literature search was conducted using Pubmed, EMBASE searching for case reports and observational studies reporting iatrogenic psychotic symptoms by patients with PD.ResultsMs. C. was a 65-year old woman with PD who was observed in a polyclinic setting and who used a levodopa/carbidopa combination. She developed paranoid psychosis with a following admission to the psychiatric ward. We have gradually lowered the dose of anti-Parkinson medication. Subsequently, treatment with clozapine was initiated and the psychotic symptoms resolved within five months.ConclusionParkinson psychosis is due to a complex interaction of neurodegenerative changes and pharmacological therapy. Therefore, the role of iatrogenic factors must be always carefully assessed. Psychosis inducting agents should be lowered or stopped before the treatment with antipsychotic medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Methods nurses with violent and aggressive patient / Postupci medicinske sestre i tehničara sa nasilnim i agresivnim bolesnikom

2014 ◽  
Vol 1 (1) ◽  
pp. 32
Author(s):  
Vesna Cmiljanić
Keyword(s):  
Aggressive Behavior ◽  
Violent Behavior ◽  
Psychiatric Ward ◽  
Medical Interventions ◽  
Emergency Situations ◽  
Short Period ◽  
Level Of Knowledge ◽  
High Level ◽  
And Training

Aggression is an act of threats directed at others who may be verbal, physical or sexual nature. Medical management of aggressive behavior among the psychiatric emergency area in which decisions must be made quickly in a short period of time. Quality of medical services largely depends on the level of knowledge and training of nurses. High frequency and diversity of occurrence of aggressive and violent behavior by the medical staff not only to the psychiatric ward, the necessity to a wider range of health professionals meet and train to work with such patients in first aid, health care and therapy. For emergencies in psychiatry, particularly aggressive behavior, most often there is no time for planning and setting goals of care. These conditions require a high level of expertise, training and knowledge of the medical technicians to act “here and now”. Working with these patients has its own characteristics and is different from other medical interventions in emergency situations.

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