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Deconstructing violence in acutely exacerbating psychotic patients

Published online by Cambridge University Press:  09 July 2020

Andrea Nichtová Open the ORCID record for Andrea Nichtová [Opens in a new window] ,
Jan Volavka ,
Jan Vevera Open the ORCID record for Jan Vevera [Opens in a new window] ,
Kateřina Příhodová ,
Veronika Juríčková ,
Anna Klemsová ,
Marek Páv ,
Věra Strunzová ,
Tereza Příhodová  and
Marcela Nocárová
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Andrea Nichtová
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic Psychiatric Hospital Bohnice, Prague, Czech Republic
Jan Volavka
Affiliation:
Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University, Prague, Czech Republic
Jan Vevera*
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic Department of Psychiatry, Faculty of Medicine, University Hospital in Pilsen, Charles University, Prague, Czech Republic Center for epidemiological and clinical research in Addictions, National Institute of Mental Health, Klecany, Czech Republic Department of Psychiatry, Institute for Postgraduate Medical Education Prague, Prague, Czech Republic
Kateřina Příhodová
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic Center for epidemiological and clinical research in Addictions, National Institute of Mental Health, Klecany, Czech Republic
Veronika Juríčková
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic Center for epidemiological and clinical research in Addictions, National Institute of Mental Health, Klecany, Czech Republic
Anna Klemsová
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
Marek Páv
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic Psychiatric Hospital Bohnice, Prague, Czech Republic
Věra Strunzová
Affiliation:
Department of Psychiatry, Institute for Postgraduate Medical Education Prague, Prague, Czech Republic Institute of Clinical and Experimental Medicine, Prague, Czech Republic
Tereza Příhodová
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic Center for epidemiological and clinical research in Addictions, National Institute of Mental Health, Klecany, Czech Republic University of New York in Prague, Prague, Czech republic
Marcela Nocárová
Affiliation:
Psychiatric Hospital Dobřany, Dobřany,Czech Republic
Eva Papoušková
Affiliation:
Psychiatric Hospital Dobřany, Dobřany,Czech Republic
Petr Žižka
Affiliation:
Psychiatric Hospital Dobřany, Dobřany,Czech Republic
Lucie Kališová
Affiliation:
Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
*
*Author for correspondence: Jan Vevera, Email: veverajan@gmail.com
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Abstract

Background

This study examined the proximate causes of psychotic patients’ aggression upon the admission to the psychiatric wards of a university and two state hospitals.

Methods

The authors used a semistructured interview to elicit proximate causes of assaults from the assailants and victims. The treating psychiatrists and nurses provided additional information. Based on this interview, aggressive episodes were categorized as psychotic, impulsive and planned.

Results

A total of 820 assaults committed by 289 newly admitted violent psychotic inpatients were evaluated. The interview ratings indicated that 76.71% of the assaults were directly driven by psychotic symptoms and 22.32% of all attacks were labeled as impulsive. Only 0.98% of assaults were categorized as planned.

Conclusions

These findings indicate that assaultive behavior among recently admitted acute psychiatric inpatients with untreated or undertreated psychosis is primarily driven by psychotic symptoms and disordered impulse control. Because each type of assault requires a different management, identifying the type of assault is crucial in determining treatment interventions.

Keywords

Aggressionproximate causespsychosisdisordered impulse controlplanned
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 6: Special Issue: Functional Neurological Disorder , December 2021 , pp. 643 - 647
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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