OBJECTIVE: The study assessed the frequency of violence by patients two
weeks after discharge from a psychiatric hospital and identified
characteristics of patients with an increased risk of violence after
discharge. METHODS: A structured form was used to interview patients aged
18 to 59 years in a private university psychiatric hospital. Patients
provided self-reports of past violence, and violence while in the hospital
was assessed by routine nurse ratings. Patients were telephoned two weeks
after discharge to assess violence since discharge. RESULTS: Sixteen of 430
patients who were interviewed by telephone two weeks after discharge
reported violence against persons since their discharge. Patients who were
violent in the month before admission were nine times more likely to be
violent in the two weeks after discharge, compared with patients who were
not violent just before admission. Patients with a personality disorder
were four times more likely than patients without a personality disorder to
be violent after discharge. The targets of violence were often family
members or other intimates and often the same persons attacked before
hospitalization. CONCLUSIONS: Patients who were violent just before
admission were more likely to be violent after discharge and to attack the
same persons they had attacked in the past. Clinicians should routinely
evaluate past violence and work with the patient and potential targets of
violence to prevent future violence.
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