Psychiatric Bulletin (2008) 32: 455-458. doi: 10.1192/pb.bp.107.015412
© 2008 The Royal College of Psychiatrists
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Aggressive incidents on a psychiatric intensive care unit

Dermot P. Cohen, Registrar, Mohammed Saleem Akhtar, Senior Registrar, Adeel Siddiqui, Registrar, Cathy Shelley, Clinical Nurse Manager II, Conal Larkin, Medical Director and Consultant General Adult Psychiatrist and Anthony Kinsella, Statistician

St John of God Hospital, Stillorgan, Co Dublin

Eadbhard O’Callaghan, Professor of Psychiatry and Consultant Adult Psychiatrist

Cluain Mhuire Family Centre, Blackrock, Co Dublin

Abbie Lane, Consultant General Adult Psychiatrist

Dublin County Stress Clinic, St John of God Hospital, Stillorgan, Co Dublin, email: abbie.lane{at}sjog.ie

Declaration of interest

None.

AIMS AND METHOD

This study looked at patient aggressive behaviour on an Irish psychiatric intensive care unit, and whether it was related to diagnosis, patient’s insight and symptomatology. Each aggressive incident was recorded throughout the patient’s stay using the Staff-Observed Aggression Scale.

RESULTS

Ninety-nine individuals were admitted to the unit during the study. We recorded 82 aggressive incidents, with most occurring during the daytime and on weekdays. There was no statistical difference in BPRS scores between the aggressive and non-aggressive groups. The aggressive patient group had a lower insight score than the non-aggressive group (P<0.05) as measured on the Schedule of the Assessment of Insight. However, when gender and verbal aggression only were included in the analysis, the difference in insight was less significant (P=0.07).

CLINICAL IMPLICATIONS

Aggression is common on a psychiatric intensive care unit. Low levels of insight in patients may increase the risk of aggression.