Meyer Leonardo Fernandez, Telles Lisieux E de Borba, Mecler Kátia, Soares Ana Luiza Alfaya Galego, Alves Renata Santos, Valença Alexandre Martins
Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Instituto de Perícias Heitor Carrilho (IPHC), Rio de Janeiro, RJ, Brazil.
Trends Psychiatry Psychother. 2018 Oct-Dec;40(4):310-317. doi: 10.1590/2237-6089-2017-0039.
This preliminary study aimed to identify and compare characteristics related to violent behavior in inpatients with schizophrenia at a general psychiatric hospital using the Historical, Clinical, and Risk Management 20 (HCR-20), the Modified Overt Aggression Scale (MOAS), and sociodemographic data.
Violent and nonviolent participants were selected based on psychiatric admission reports. Participants with reports of aggressive behavior and HCR-20 total score ≥ 21 upon admission were assigned to the violent patient group. Participants without aggressive behavior and with HCR-20 total score < 21 upon admission were assigned to the nonviolent patient group. The MOAS was applied to characterize the degree of severity of the violent behavior.
HCR-20 and its subscales were effective in differentiating between the violent and nonviolent participant groups. Twelve of the 20 HCR-20 items were useful for distinguishing between the groups, although total HCR-20 scores were more reliable when applied to the nonviolent patient group. The MOAS did not show high degrees of severity for the types of aggression observed in the participants.
HCR-20 was useful and reliable for distinguishing between violent and nonviolent patients with schizophrenia in this clinical psychiatric setting. Item analysis identified the most relevant characteristics in each group. The use of the HCR-20 in clinical psychiatric settings should be encouraged.
本初步研究旨在使用历史、临床及风险管理20项清单（HCR - 20）、改良外显攻击量表（MOAS）以及社会人口统计学数据，识别并比较一家普通精神病院精神分裂症住院患者中与暴力行为相关的特征。
根据精神科入院报告选取暴力和非暴力参与者。入院时有攻击行为报告且HCR - 20总分≥21分的参与者被分配到暴力患者组。入院时无攻击行为且HCR - 20总分<21分的参与者被分配到非暴力患者组。应用MOAS来描述暴力行为的严重程度。
HCR - 20及其子量表在区分暴力和非暴力参与者组方面有效。HCR - 20的20个项目中有12个对区分两组有用，尽管将HCR - 20总分应用于非暴力患者组时更可靠。MOAS对于参与者中观察到的攻击类型未显示出高度的严重性。
在这种临床精神病学环境中，HCR - 20对于区分精神分裂症暴力和非暴力患者是有用且可靠的。项目分析确定了每组中最相关的特征。应鼓励在临床精神病学环境中使用HCR - 20。
