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Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: Systematic Review and Meta-Analysis—A 2019 Update

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Violence and Mental Disorders

Part of the book series: Comprehensive Approach to Psychiatry ((CAP,volume 1))

Abstract

Violence by patients in acute psychiatric wards affects both patients and staff. This study updates a 2015 meta-analysis of the prevalence of violent patients in acute psychiatric wards. Forty-two studies conducted in high-income countries were located in searches of the electronic databases PubMed, Scopus, and CINAHL. The pooled prevalence of reported acts of violence by patients was 18% (95% CI), although with very high heterogeneity (I2 = 98.7%, Q = 1735.3, p < 0.0001). Analysis of moderator variables found that 17.9% of the between-study heterogeneity was explained by the proportion of males (p = 0.0035), 16.4% by ward size (p = 0.0217), 12.8% by the proportion of involuntary patients (p = 0.0225), and 36.1% by the proportion of patients with alcohol-use disorder (p = 0.0007). The proportion of patients with other diagnoses, including psychotic illness, was not a source of heterogeneity.

The continued high rate of violence confirms the need for improvement in the identification and containment of violent behavior in psychiatric wards in order to provide safer and more therapeutic environments.

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Authors and Affiliations

  1. School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy

    Ester di Giacomo

  2. Department of Mental Health and Addiction, ASST Monza, Monza, Italy

    Ester di Giacomo

  3. Unit of Epidemiological and Evaluation Psychiatry, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy

    Laura Iozzino & Giovanni de Girolamo

  4. Unit of Statistics, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy

    Clarissa Ferrari

  5. Department of Statistical Science, ‘La Sapienza’ University, Rome, Italy

    Cosmo Strozza

  6. Interdisciplinary Centre on Population Dynamics (CPOP), Southern Denmark University, Odense, Denmark

    Cosmo Strozza

  7. Prince of Wales Hospital Sydney, Sydney, Australia

    Matthew Large

  8. University of New South Wales, Sydney, Australia

    Matthew Large

  9. Faculty of Medicine and Health Science, Macquarie University, Sydney, Australia

    Olav Nielssen

Authors
  1. Ester di Giacomo
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  2. Laura Iozzino
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  3. Clarissa Ferrari
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  4. Cosmo Strozza
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  5. Matthew Large
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  6. Olav Nielssen
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  7. Giovanni de Girolamo
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Correspondence to Giovanni de Girolamo .

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Editors and Affiliations

  1. Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy

    Bernardo Carpiniello

  2. Department of Clinical and Experimental Science, University of Brescia, Brescia, Italy

    Antonio Vita

  3. Department of Neuroscience, Luigi Sacco Hospital, Milano, Italy

    Claudio Mencacci

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di Giacomo, E. et al. (2020). Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: Systematic Review and Meta-Analysis—A 2019 Update. In: Carpiniello, B., Vita, A., Mencacci, C. (eds) Violence and Mental Disorders. Comprehensive Approach to Psychiatry, vol 1. Springer, Cham. https://doi.org/10.1007/978-3-030-33188-7_10

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  • DOI: https://doi.org/10.1007/978-3-030-33188-7_10

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