Correlates of accuracy in the assessment of psychiatric inpatients'risk of violence.
The authors evaluated characteristics of patients whom clinicians accurately assessed as being at high or low risk for violence and patients for whom clinicians overestimated or underestimated the risk.
At admission, physicians estimated the probability that each of 226 psychiatric in patients would physically attack someone during the first week of hospitalization.
Nurses rated assaultive behavior in the hospital with the Overt Aggression Scale.
Acute symptoms were rated with the Brief Psychiatric Rating Scale.
For the group as a whole, assessed levels of risk were substantially related to later physical aggression (sensitivity=67%, specificity=69%). Multinomial logit analysis showed that patients with psychotic disorders such as schizophrenia, organic psychotic conditions, and mania were more likely to be accurately assessed by clinicians as being at high risk (true positives) than to be true negatives or false positives.
A recent history of violence was associated with higher estimated risk but did not distinguish true positives from false positives.
While clinicians can accurately classify the potential for violence in the majority of patients at admission, systematic errors characterize inaccurate assessments of the risk.
Awareness of these patterns may help improve assessment of the risk of violence in clinical practice.
Mots-clés Pascal : Trouble psychiatrique, Diagnostic, Violence, Trouble comportement social, Hospitalisation, Service hospitalier, Psychiatrie, Facteur risque, Erreur estimation, Personnel sanitaire, Homme
Mots-clés Pascal anglais : Mental disorder, Diagnosis, Violence, Social behavior disorder, Hospitalization, Hospital ward, Psychiatry, Risk factor, Estimation error, Health staff, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0381030
Code Inist : 002B18B04. Création : 01/03/1996.