Steinert Tilman
Zentrum für Psychiatrie, Die Weissenau, Ravensburg, Germany.
Psychiatr Prax. 2002 Mar;29(2):61-7. doi: 10.1055/s-2002-22038.
The assessment of violence risk has impact on psychiatrists' decisions not only in forensic psychiatry but concerns many aspects of civil psychiatric units, too. Within the last decade, many studies on violence have been published. The results are misinterpreted sometimes.
A review about studies on in-patient violence is given.
In-patient violence and violence in the community should strictly be separated concerning predictors and predictions. Predictors of community violence both for persons with major mental disorders and persons without mental illness are criminal history, male gender, younger age, and substance abuse. Psychopathological and clinical variables play a minor role. In contrast, in-patient violence is closely related to the severity of psychopathological symptoms. More detailed determinations of risk-related symptoms yield conflicting results due to inevitable problems of sample selection.
The assessment of violence risk has to consider the different risk constellations for violence in institutions and in the community. Predictions of violence by individual risk variables are limited because situation-related factors are important, too.
暴力风险评估不仅会影响法医精神病学领域精神科医生的决策，在民事精神科单元的诸多方面也会产生影响。在过去十年间，发表了许多关于暴力行为的研究。但其结果有时会被误解。
对住院患者暴力行为的研究进行综述。
在预测因素和预测方面，应严格区分住院患者暴力行为和社区暴力行为。患有严重精神障碍的人和未患精神疾病的人的社区暴力行为预测因素包括犯罪史、男性、较年轻的年龄以及药物滥用。心理病理学和临床变量所起的作用较小。相比之下，住院患者暴力行为与心理病理症状的严重程度密切相关。由于样本选择中不可避免的问题，对与风险相关症状的更详细测定会得出相互矛盾的结果。
暴力风险评估必须考虑机构和社区中不同的暴力风险情况。由于与情境相关的因素也很重要，通过个体风险变量预测暴力行为的能力有限。
