Violent behavior and association with alcohol abuse or other substance is a common problem in emergency psychiatry. Assessment, diagnosis, management and treatment of this symbiosis is very difficult. Such an association affects the severity of symptoms of mental illness, progress and prognosis.

To review the association of violent behavior with alcohol and substance abuse.

Improve assessment, management and treatment of patients with violent behavior, accompanied with alcohol and substance abuse in psychiatric ward.

Prospective cohort study, during 24 weeks. Psychiatric evaluation based on structural clinical interviews and questionnaires related to violent behaviors and risk factors were conducted to patients admitted in psychiatric hospital on UHC'Mother Tereza' Tirana.

According to our data, there are strong links between alcohol consumption, substance abuse and an individual's risk of being either a perpetrator or victim of violence. So 20% of males and 16% of female admitted to our service had reported alcohol consumption and substance abuse, (out of 159 male and 77 female patients) 66% of them had shown violence episodes. At the discharge from hospital 3.8% of men and 1.2% of female patients had diagnosis of axis I related to alcohol or substance abuse.

There is a close correlation between the Violence and abuse of Alcohol and other substances. The comorbidity affects the progress of treatment and prognosis of the disease. The abuse of alcohol and other substances is a good indicator to predict future violence.