Assaultive behaviour in psychiatrically hospitalized elderly: a response to psychosocial stimulation and changes in pharmacotherapy.

The objective of this naturalistic, non-experimental study was to observe and evaluate the relationship between psychosocial stimulation and changes in medications, and the emergence of the assaultive behaviour, as well as its 24-h course, in a psychogeriatric ward. The assaultive behaviour in 29 patients (mean age 73.9 years) was rated daily for three consecutive months. Major psychosocial stimuli and the number of medication changes were also recorded. More patients with organic brain syndromes than with non-organic conditions were aggressive. Those with organic syndromes were more likely to become aggressive within any 24 h period and their aggression was less likely to disappear. The rate with which aggression emerged changed following changes in psychotropic medications. The presence of psychosocial stimulation and changes in non-psychotropic medications modified the rate of disappearance of the aggression. In a psychogeriatric inpatient population, both prevalence and incidence of aggression, as well as its response to modifying factors, depends critically on pathogenesis. The emergence and disappearance of aggression are modified by different factors.