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Illustrative cases to support the Cal-VAT guidelines

Published online by Cambridge University Press:  30 March 2015

Laura J. Dardashti*
Affiliation:
California Department of State Hospitals (DSH), Sacramento, California, USA
Jennifer A. O’Day
Affiliation:
California Department of State Hospitals (DSH), Sacramento, California, USA Department of State Hospitals (DSH)–Metropolitan, Norwalk, California
Michael W. Barsom
Affiliation:
Department of State Hospitals (DSH)–Metropolitan, Norwalk, California
Eric H. Schwartz
Affiliation:
California Department of State Hospitals (DSH), Sacramento, California, USA Department of State Hospitals (DSH)–Vacaville, Vacaville, California
George J. Proctor
Affiliation:
California Department of State Hospitals (DSH), Sacramento, California, USA Department of State Hospitals (DSH)–Patton, Patton, California
*
*Address for correspondence: Laura J. Dardashti, California Department of State Hospitals, 1600 9th Street, Room 400, Sacramento, CA 95814, USA. (Email: [email protected])

Abstract

There is increasing interest in developing more nuanced methods for managing aggression and violence in long-term psychiatric inpatient settings. However, the dearth of controlled studies has, at times, hampered presentation of viable options. Following the publication of guidelines developed in the California State Hospital forensic system, the authors present a group of 7 cases illustrating different approaches to violence management, including pharmacological, psychotherapeutic, and environmental interventions.

Type
Case-Based Review Article
Copyright
© Cambridge University Press 2015 

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References

1. Dack, C, Ross, J, Papadopoulos, C, Stewart, D, Bowers, L. A review and meta-analysis of the patient factors associated with psychiatric in-patient aggression. Acta Psychiatr Scand. 2013; 127(4): 255268.CrossRefGoogle ScholarPubMed
2. Nolan, KA, Czobor, P, Roy, BB, et al. Characteristics of assaultive behavior among psychiatric inpatients. Psychiatr Serv. 2003; 54(7): 10121016.Google Scholar
3. Quanbeck, CD, McDermott, BE, Lam, J, Eisenstark, H, Sokolov, G, Scott, CL. Categorization of aggressive acts committed by chronically assaultive state hospital patients. Psychiatr Serv. 2007; 58(4): 521528.Google Scholar
4. Morrissette, DA, Stahl, SM. Treating the violent patient with psychosis or impulsivity utilizing antipsychotic polypharmacy and high-dose monotherapy. CNS Spectr. 2014; 19(5): 439448.Google Scholar
5. Nielsen, J, Dahm, M, Lublin, H, Taylor, D. Psychiatrists’ attitude towards and knowledge of clozapine treatment. J. Psychopharmacol. 2010; 24(7): 965971.Google Scholar
6. Stahl, SM, Morrissette, DA, Cummings, M, et al. California State Hospital Violence Assessment and Treatment (Cal-VAT) guidelines. CNS Spectr. 2014; 19(5): 449465.CrossRefGoogle ScholarPubMed
7. Kelly, DL, Richardson, CM, Yu, Y, Conley, RR. Plasma concentrations of high-dose olanzapine in a double-blind crossover study. Hum Psychopharmacol. 2006; 21(6): 393398.Google Scholar
8. Hirschfeld, RM, Allen, MH, McEvoy, JP, Keck, PE Jr, Russell, JM. Safety and tolerability of oral loading divalproex sodium in acutely manic bipolar patients. J Clin Psychiatry. 1999; 60(12): 815818.Google Scholar
9. Kane, J, Honigfeld, G, Singer, J, Meltzer, H. Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988; 45(9): 789796.CrossRefGoogle ScholarPubMed
10. Volavka, J, Czobor, P, Nolan, K, et al. Overt aggression and psychotic symptoms in patients with schizophrenia treated with clozapine, olanzapine, risperidone, or haloperidol. J Clin Psychopharmacol. 2004; 24(2): 225228.Google Scholar
11. Frogley, C, Taylor, D, Dickens, G, Picchioni, M. A systematic review of the evidence of clozapine’s anti-aggressive effects. Int J Neuropsychopharmacol. 2012; 15(9): 13511371.Google Scholar
12. Shelton, D, Sampl, S, Kesten, KL, Zhang, W, Trestman, RL. Treatment of impulsive aggression in correctional settings. Behav Sci Law. 2009; 27(5): 787800.CrossRefGoogle ScholarPubMed
13. Heinrichs, RW, Zakzanis, KK. Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology. 1998; 12(3): 426445.Google Scholar
14. Keefe, RS, Bilder, RM, Harvey, PD, et al. Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology. 2006; 31(9): 20332046.Google Scholar
15. Kennedy, HG. Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment. 2002; 8(6): 433443.CrossRefGoogle Scholar
16. Hieber, R, Dellenbaugh, T, Nelson, LA. Role of mirtazapine in the treatment of antipsychotic-induced akathisia. Ann Pharmacother. 2008; 42(6): 841846.Google Scholar
17. Brown, D, Larkin, F, Sengupta, S. Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectr. 2014; 19(5): 391402.Google Scholar
18. Meltzer, HY, Alphs, L, Green, AI, et al. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry. 2003; 60(1): 8291.Google Scholar
19. Baldessarini, R, Tondo, L, Davis, P, Pompili, M, Goodwin, FK, Hennen, J. Decreased risk of suicides and attempts during long-term lithium treatment: a meta-analytic review. Bipolar Disord. 2006; 8(5 Pt 2): 625639.Google Scholar
20. Krakowski, MI, Czobor, P, Citrome, L, Bark, N, Cooper, TB. Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry. 2006; 63(6): 622629.Google Scholar