The psychopharmacology of violence: making sensible decisions

CNS Spectrums ◽  
2014 ◽  
Vol 19 (5) ◽  
pp. 411-418 ◽  
Author(s):  
Leslie Citrome ◽  
Jan Volavka
Keyword(s):  
Aggressive Behavior ◽  
Violent Behavior ◽  
Psychiatric Inpatient ◽  
Regulatory Agencies ◽  
Sublingual Administration ◽  
Pharmacological Agents ◽  
Adrenergic Agents ◽  
Acute Setting ◽  
Psychiatric Inpatient Unit ◽  
Second Generation Antipsychotics

Violent behavior associated with mental disorders is a common reason for admission to a psychiatric inpatient unit. Once hospitalized, patients may continue to be intermittently agitated and have persistent aggressive behaviors, preventing their discharge back into the community. Managing agitation quickly with effective pharmacological agents can avoid further escalation to aggression and violence. In the acute setting, this usually involves the parenteral use of antipsychotics, with or without benzodiazepines. Within the past decade, short-acting intramuscular formulations of second-generation antipsychotics have become available and provide a means to induce calm with a substantially lower risk of acute dystonia or akathisia compared with haloperidol. New alternative formulations that avoid injections include inhalation and sublingual administration. Longer-term management of persistent aggressive behavior by reducing the frequency and intensity of future episodes of agitation is more complex. In contrast to agitation associated with schizophrenia or bipolar mania, no agents have yet been approved by regulatory agencies for the treatment of persistent aggressive behavior. The strongest evidence supports the use of clozapine as an antihostility agent, followed by olanzapine. Adjunctive strategies with anticonvulsants and beta-adrenergic agents may also be worthwhile to consider.

Aggressive behavior on a women's psychiatric inpatient unit

2021 ◽  
Author(s):  
VictoriaM. Wilkins ◽  
Robert E. Kelly ◽  
Saira N. Haider ◽  
Brianna Correale ◽  
Marilyn M. Byrne ◽  
...  
Keyword(s):  
Aggressive Behavior ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Psychiatric Inpatient Unit

Participant Reactions to Suicide-Focused Research

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 367-374
Author(s):  
Sarah P. Carter ◽  
Brooke A. Ammerman ◽  
Heather M. Gebhardt ◽  
Jonathan Buchholz ◽  
Mark A. Reger
Keyword(s):  
Medical Records ◽  
Research Study ◽  
Small Sample Size ◽  
Psychiatric Inpatient ◽  
Small Sample ◽  
Inpatient Unit ◽  
Online Laboratory ◽  
Psychiatric Inpatient Unit ◽  
Before And After ◽  
Participant Reactions

Abstract. Background: Concerns exist regarding the perceived risks of conducting suicide-focused research among an acutely distressed population. Aims: The current study assessed changes in participant distress before and after participation in a suicide-focused research study conducted on a psychiatric inpatient unit. Method: Participants included 37 veterans who were receiving treatment on a psychiatric inpatient unit and completed a survey-based research study focused on suicide-related behaviors and experiences. Results: Participants reported no significant changes in self-reported distress. The majority of participants reported unchanged or decreased distress. Reviews of electronic medical records revealed no behavioral dysregulation and minimal use of as-needed medications or changes in mood following participation. Limitations: The study's small sample size and veteran population may limit generalizability. Conclusion: Findings add to research conducted across a variety of settings (i.e., outpatient, online, laboratory), indicating that participating in suicide-focused research is not significantly associated with increased distress or suicide risk.

scholarly journals The experience of parents faced with the admission of their adolescent to a child and adolescent psychiatric inpatient unit. A qualitative study with focus groups

2021 ◽  
Author(s):  
Beatriz Merayo-Sereno ◽  
Aránzazu Fernández-Rivas ◽  
Keyth Lany de Oliveira-Silva ◽  
Francisco-Javier Sánchez-Andérez ◽  
Eva Sesma-Pardo ◽  
...  
Keyword(s):  
Focus Groups ◽  
Psychiatric Hospitalization ◽  
Emotional Experience ◽  
Psychiatric Inpatient ◽  
Health Behavior Change ◽  
Child And Adolescent ◽  
Inpatient Unit ◽  
Entire Family ◽  
Parental Experience ◽  
Psychiatric Inpatient Unit

AbstractThe admission of an adolescent to a child and adolescent psychiatric inpatient unit has a serious impact on the entire family unit. The emotional experience of those primary caregivers has been scarcely studied qualitatively despite being recommended by previous research. This study aims to examine the experience of parents of adolescents with mental health needs that required psychiatric hospitalization in a child and adolescent unit. Qualitative cross-sectional research was carried out under the recommendations of Grounded Theory with three Focus Groups of parents (N = 22) of adolescents who required psychiatric hospitalization in a child and adolescent ward. The COREQ quality criteria were applied. The parental experience implies a high level of emotional suffering modulated by feelings of guilt, stigma, parental awareness of their child’s illness and the passage of time. The use of Prochaska’s and Diclemente’s trans-theoretical model of health behavior change is useful in understanding the parental experience.

scholarly journals FAMILY EXPECTATIONS ABOUT A PSYCHIATRIC INPATIENT UNIT

2015 ◽  
Vol 24 (4) ◽  
pp. 984-992 ◽  
Author(s):  
Gustavo Costa de Oliveira ◽  
Jacó Fernando Schneider ◽  
Cíntia Nasi ◽  
Marcio Wagner Camatta ◽  
Agnes Olschowsky
Keyword(s):  
Social Relations ◽  
Psychiatric Inpatient ◽  
Family Care ◽  
Inpatient Unit ◽  
University Hospital ◽  
Family Expectations ◽  
Phenomenological Sociology ◽  
Psychiatric Inpatient Unit ◽  
The Social ◽  
The Family

ABSTRACT We aimed to understand the expectations of families about a Psychiatric Inpatient Unit in the perspective of Alfred Schutz's phenomenological sociology. This is a qualitative and phenomenological research, with families of patients at a psychiatric inpatient unit of a university hospital in the state of Rio Grande do Sul, Brazil. Data were collected through phenomenological interviews, and the analysis was constructed in the light of phenomenological sociology. The results show that the expectations of the family in the Psychiatric Inpatient Unit are related to the interpretation and experiences they have in the world of everyday life; that these expectations should be valued in patient and family care; and that they may integrate the family in care for the patient. We hope to contribute so that professionals and managers reflect about the importance of understanding the expectations of families on a Unit, aiming to implement more effective health actions, based on the social relations among the subjects.

scholarly journals Predicting the Effect of Violent Gameplaying to Violent Behavior Intention among Females using Tree Regression and AdaBoost Tree Regression

2021 ◽  
Vol 4 (2) ◽  
pp. 62-66
Author(s):  
Maniah Maniah ◽  
Yaya Heryadi ◽  
Agung Trisetyarso ◽  
Bachtiar Saleh Abbas ◽  
Wayan Suparta ◽  
...  
Keyword(s):  
Aggressive Behavior ◽  
Video Game ◽  
Violent Behavior ◽  
Quantitative Measure ◽  
High Accuracy ◽  
Adaptive Boosting ◽  
Behavior Intention ◽  
Video Game Playing ◽  
Violent Video Game ◽  
Behavior Intentions

The issue on the effect of violent video game to aggressive behavior has gained wide interest from various communities. This paper presents some results of predicting quantitative measure of aggressive behavior from variables that measure violent video game playing. Experiment results showed that Decision Tree Regression (DTR) and Adaptive Boosting Tree Regression (AB-DTR) models predicted aggressive behavior intentions with high accuracy. For predicting Hostile variable: DTR’s training and testing RMSE (0.0, 0.0); AB-DTR’s training and testing RMSE (0.08, 1.08). For predicting Instru variable: DTR’s training and testing RMSE (0.0, 2.18); AB-DTR’s training and testing RMSE (0.0, 3.30) respectively.

scholarly journals Patient access to psychiatric records: experience in an in-patient unit

1995 ◽  
Vol 19 (2) ◽  
pp. 87-90 ◽  
Author(s):  
Nick Kosky ◽  
Tom Burns
Keyword(s):  
Educational Attainment ◽  
Maintenance Treatment ◽  
Junior Doctor ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Therapeutic Relationships ◽  
Patient Access ◽  
Psychiatric Inpatient Unit ◽  
Lower Educational Attainment

Forty of 46 consecutive admissions to a psychiatric inpatient unit were encouraged to read their admission notes and discuss them with the Junior doctor. The offer was withheld for two patients with organic impairment. Twenty-eight patients (including 12 on compulsory admissions) accepted the offer. The 12 who refused were characterised by overall lower educational attainment. Diagnosis raised only a few problems, prognosis and maintenance treatment being the focus of most discussions. There was no evidence of a deterioration in the quality of notes or therapeutic relationships as a consequence of access. Only in one case was the exercise judged ‘harmful’, but ‘useful or essential’ in 22. Possible benefits for both patients and doctor are explored.

Efektifitas Teknik De-Eskalasi Untuk Mengurangi Agresifitas Pasien Skizofrenia : Literature Review

2021 ◽  
Vol 1 ◽  
pp. 1442-1451
Author(s):  
K Keswanto ◽  
Eka Budiarto
Keyword(s):  
Literature Review ◽  
Aggressive Behavior ◽  
Violent Behavior ◽  
Self Injury ◽  
Literature Evidence ◽  
Schizophrenic Patients ◽  
And Behavior ◽  
Attitudes And Behavior ◽  
Commit Suicide

AbstractSchizophrenia is a disease that attacks the nervous system that can cause changes in attitudes and behavior. Schizophrenic patients are prone to have aggressive behavior that can cause a loss of control of a person's behavior that is directed at oneself, others, or the environment. Violent behavior in oneself can take the form of self-injury to commit suicide or allow oneself to be in the form of self-abandonment. One technique to reduce aggressive behavior in schizophrenic patients is the de-escalation technique. This study aims to determine the effectiveness of de-escalation techniques to reduce aggressive behavior in schizophrenic patients based on available literature evidence. The study used a literature review method. The databases used to search articles are Wiley, PubMed, Science Direct, and the Google scolar search engine. Articles are selected based on the suitability of the keywords, topics and inclusion and exclusion criteria that have been determined. The search results obtained as many as 5 articles, 4 articles in Indonesian and 1 in English. The critical review instrument used to assess the quality of the article is the instrument by Hawker. There are findings that de-escalation techniques are effective in reducing aggressiveness in schizophrenic patients. Efforts to reduce aggressive behavior with de-escalation techniques have a more significant effect than those without de-escalation techniques.Keywords: Aggressive behavior, risk of violent behavior, de-escalation technique, Schizophrenia. AbstrakSkizofrenia merupakan penyakit yang menyerang sistem saraf yang dapat menyebabkan perubahan sikap dan perilaku. Pasien skizofrenia rentan memiliki perilaku agresif yang dapat menyebabkan hilangnya kendali perilaku seseorang yang diarahkan pada diri sendiri, oranglain, atau lingkungan. Perilaku kekerasan pada diri sendiri dapat berbentuk melukai diri untuk bunuh diri atau membiarkan diri dalam bentuk penelantaran diri. Salah satu teknik untuk mengurangi perilaku agresif pada pasien skizofrenia adalah dengan teknik deeskalasi. Penelitian ini bertujuan untuk mengetahui efektifitas teknik deeskalasi untuk mengurangi perilaku agresif pada pasien skizofrenia berdasarkan literatur evidence yang tersedia. Penelitian menggunakan metode literature review. Database yang digunakan untuk pencarian artikel adalah Wiley, PubMed, Science Direct, serta mesin pencarian Google scolar. Artikel diseleksi berdasarkan kesesuaian dengan kata kunci, topik serta kriteria inklusi dan eksklusi yang telah ditentukan. Hasil penelusuran didapatkan sebanyak 5 artikel, 4 artikel berbahasa Indonesia dan 1 berbahasa inggris. Instrumen telaah kritis yang digunakan untuk menelaah kualitas artikel adalah instrumen oleh Hawker. Terdapat temuan bahwa teknik deeskalasi efektif dalam mengurangi agresifitas pada pasien skizofrenia. Upaya untuk menurunkan perilaku agresif dengan teknik de-esakalasi memberikan pengaruh lebih signifikan dibandingkan dengan yang tidak diberikan teknik de-eskalasi. Kata Kunci : Perilaku agresif, Resiko perilaku kekerasan, Teknik deeskalasi, Skizofrenia.

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