Prospective study into factors associated with aggressive incidents in psychiatric acute admission wards.

BACKGROUND

Factors associated with aggression among psychiatric in-patients are still poorly understood. Inconsistent published findings are partly attributable to methodological problems. Much previous research has been under taken in specialist settings, where conditions are likely to differ from those in acute admission wards.

METHOD

Levels of aggression were ascertained weekly by staff report, using a reliable measure, for every patient on five acute admission wards and one locked intensive care ward at two hospitals prospectively over a five-month period.

RESULTS

Levels of aggression varied considerably among the admission wards. Aggression was more common on the locked ward and among younger patients. Factors associated with aggression changed with time since admission (seldom examined in previous studies). Complex associations were found with gender, ethnic group and diagnosis.

CONCLUSIONS

Some of the findings might be explicable by differences in ward environment, and staff-patient inter-actions. Further investigation into these is warranted.