Roaldset John Olav, Gustavsen Carina C, Lockertsen Øyvind, Landheim Torbjørn, Bjørkly Stål K
Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Department of Child and Adolescent Psychiatry, Oslo University Hospital, Oslo, Norway.
Front Psychiatry. 2023 Jul 26;14:1210871. doi: 10.3389/fpsyt.2023.1210871. eCollection 2023.
The reason for this study was the void of validated risk assessment screening tools for violence in adolescence psychiatry. Our aims were to test the predictive validity and feasibility of a pilot version of the Violence Risk Screening for Youth (V-RISK-Y). The V-RISK-Y was based on a violence risk screen for adults, the V-RISK-10, and adapted to adolescents, resulting in 12 risk items that are scored for (a) presence and (b) relevance for future violence. In this naturalistic, prospective observational study, the V-RISK-Y was scored at admission and compared with recorded episodes of violent acts and threats during hospital stay. The target population was all 92 patients admitted to the emergency department of adolescent psychiatry at Oslo University Hospital for 1 year, of which 67 patients were scored with the V-RISK-Y at admission and constituted the study sample. The predictive validity of the V-RISK-Y for violent behavior showed an AUC of 0.762 ( = 0.006). Staff approved the screener and found it to be equally or better usable than the V-RISK-10, which was previously used in the department. Still, a high proportion of raters failed to follow the scoring instructions of relevance scores, reducing feasibility. The results must be interpreted within the limits of a pilot study and low power. We conclude that results suggest changes of certain parts of the V-RISK-Y and provide a basis for testing a revised edition of the screener in a more comprehensive study, preferably with a multicenter design.
开展这项研究的原因是青少年精神病学领域缺乏经过验证的暴力风险评估筛查工具。我们的目标是测试青少年暴力风险筛查（V-RISK-Y）试点版本的预测效度和可行性。V-RISK-Y基于成人暴力风险筛查工具V-RISK-10，并针对青少年进行了调整，形成了12个风险项目，这些项目根据（a）是否存在以及（b）与未来暴力行为的相关性进行评分。在这项自然主义的前瞻性观察研究中，V-RISK-Y在入院时进行评分，并与住院期间记录的暴力行为和威胁事件进行比较。目标人群是奥斯陆大学医院青少年精神病急诊科1年内收治的所有92名患者，其中67名患者在入院时使用V-RISK-Y进行评分，构成研究样本。V-RISK-Y对暴力行为的预测效度显示曲线下面积（AUC）为0.762（P = 0.006）。工作人员认可该筛查工具，认为其可用性与之前科室使用的V-RISK-10相当或更好。然而，仍有很大比例的评分者未遵循相关性评分的计分说明，降低了可行性。本研究结果必须在试点研究及低效能的限制范围内进行解读。我们得出结论，结果表明V-RISK-Y的某些部分需要修改，并为在更全面的研究（最好采用多中心设计）中测试修订版筛查工具提供了依据。
