Assessment of violence and aggression in psychiatric settings: Descriptive approaches -

Assessment of violence and aggression in psychiatric settings: Descriptive approaches Despite its clinical importance, aggression is a scarcely studied topic. This is mostly due to the innate nature of the conditions encircling the aggressive psychiatric patient. However, this vital psychiatric state should be described and intervention methods should be defined. Therefore, in this study aimed to present a systematic review of available data on description and management of aggression and violence in psychiatric settings. First part of this 2 part review deals with description and epidemiology of violence, while second part focuses on interventions for violent patients. A comprehensive Medline search was carried out using words; aggression, agitation, excitation, violence. More than 5000 papers retrieved in English were examined considering the objectives of this review. The majority of the studies have demonstrated a moderate association between mental illness and violence. The relationship between violence and mental illness vary considerably across different diagnoses. The highest rate of violence is reported in subjects with substance abuse disorder and antisocial personality disorder. Recent studies demonstrated that clinicians have some ability, albeit limited, to predict future violence. Although, unaided clinical assessment and judgment are used in everyday practice, methods such as actuarial assessment, guided clinical assessment and integrated approach have been proposed to increase the reliability and predictability of risk assessment. Among the risk factors proposed so far past violence behaviours reported to have the highest predictive value. To date we have some tools to estimate roughly probability of future violence and take appropriate measures in order to prevent unwanted consequences.