Psychiatria pre prax 4/2010
Aggressive behavior occurrence among psychiatric inpatients in Psychiatric Hospital Hronovce during the years 2006 – 2008
Aggressiveness and its present manifestations represent social problem, which is also closely related to psychiatry and psychiatric patients. There is the myth of menace of mentally ill people. Aggression is a phenomenon related to aggressive person. However its incidence does not exclusively corresponds to mental disorder and there are many aspects such as constitutional, situational, social and ethical - moral factors which can be involved in aggressive behavior. We focused on mapping the occurrence of aggressive manifesta-tions during inpatient psychiatric care. Method: Retrospective analysis, collected data were coupled with aggressive manifestations of hospitalized patients in Psychiatric Hospital Hronovce over three years (2006 – 2008). Aggressiveness was evaluated in terms of diagnosis, sex and type of violent behavior (verbal, brachial, aggression against things, repeated signs). The second part is addressed to managing aggression in the immediate and long term point of view. Results: There were 479 different aggressive attacks events out of 3 630 hospitalized patients during three years. Only 187 patients committed those 479 attacks that means 5,1 % patients showed aggressive behavior. 14 % aggressors accomplished multiple attacks which gives 0,7 % of the total number of patients. The most frequent aggressive attacks were associated with mental retardation, schizophrenia and schizoaffective disorder. Its incidence was approximately equal in both sexes but males outnumbered females when serious violent attacks with injury were assessed. Verbal and restraint techniques were used mostly in the acute management. Acute medication was given only about a third of attacks. In the long term treatment for psychosis, it was necessary to use supramaximal dose of neuroleptics and their combination. Antipsychotic drugs was necessary to use in 96 % of patients with mental retardation.
Keywords: aggression, inpatient care, psychiatric diagnosis.
