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

中文翻译：

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解构精神病急性加重患者的暴力行为


背景本研究调查了精神病患者在进入一所大学和两家公立医院的精神病病房后出现攻击行为的近因。方法作者采用半结构化访谈来引出攻击者和受害者攻击的近因。治疗的精神科医生和护士提供了更多信息。根据这次访谈，攻击性发作被分为精神病性、冲动性和有计划性。 结果对 289 名新入院的暴力精神病住院患者实施的 820 起攻击行为进行了评估。访谈评级显示，76.71%的攻击行为是由精神病症状直接驱动的，22.32%的攻击行为被标记为冲动。只有 0.98% 的攻击行为被归类为有计划的。结论这些研究结果表明，最近入院的患有未经治疗或治疗不足的精神病的急性精神病住院患者的攻击行为主要是由精神病症状和冲动控制紊乱引起的。由于每种类型的攻击需要不同的管理，因此识别攻击类型对于确定治疗干预措施至关重要。