Psyhiatrists who work in hospitals and treat patients who show aggression present particular challenges. The course and treatment of serious psychiatric disorders can be complicated because of the comorbidity with substance abuse. The objective of the present study is the drug treatment of aggression among in-patients with serious mental disorder.

The participants (423 patients) were randomly screened among the in-patients of the 9 acute departments of PHA (Psyhiatric Hospital of Attica). For the statistical analysis, the program SPSS was used.

The participants (423 patients): average age 45.9 years old (sd = 13.1), 60.8% men, 63.7% involuntary admitted, disorder onset: 28.4 years (sd = 12.1), diagnosis of Schizophrenia 72.1%, Bipolar disorder 16.8%, Depression 11.1% with substance abuse in 18.7%, and reason of admission: auto/hetero- agression 24.3%, relapse of the disease 46.1%, interruption of drug therapy 27%. 67,5% showed aggression at the admission, 25.6% were administered more than one antipsychotic drug at the admission, along with benzodiazepines in 53.7%. During their hospitalization, aggression was reduced to 22.9%, with verbal aggression first in line with 14.4%, and 41.9% of the patients were administered more than one antipsychotic drug. The SGAs dominated and were administered in combination with stabilizers, antidepressants and benzodiazepines.

There are few documented points to guide daily practice, and it seems that case reports, advices from other colleagues and/or personal experience may influence in an important way the therapy of psychiatric patients who show aggressive behavior.