Palmstierna T, Olsson D
Department of Clinical Neuroscience, Karolinska Institutet, Division of Forensic Psychiatry, Stockholm, Sweden.
Acta Psychiatr Scand. 2007 Jan;115(1):66-72. doi: 10.1111/j.1600-0447.2006.00853.x.
To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse.
All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates.
Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found.
In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics.
同时评估因严重药物滥用而被非自愿收治的女性患者发生严重住院暴力行为的精算预测因素和动态预测因素。
对瑞典收治有潜逃倾向、既往有暴力行为、药物滥用的女性患者的特殊机构中的所有患者,使用修订后的工作人员观察攻击量表进行评估。收集暴力风险因素的精算数据,并在一个扩展的Cox比例风险模型中进行考量,该模型包含多个事件,且将每日评估的布罗泽特暴力清单作为时间依存性协变量。
轻度暴力行为和受非法药物影响是24小时内严重暴力行为的最佳预测因素。不同机构之间在暴力风险方面也存在显著差异。
住院暴力风险随时间迅速变化,受非法药物影响和表现出轻度暴力行为是重要的动态预测因素。患者之间暴力行为的差异无法通过患者特征来解释。