Background:
Aggression is a common clinical issue arising during treatment of young people with mental health problems. Poorly managed aggressive behaviours can compromise the therapeutic environment and pose a safety risk to patients and staff. The aim of this study was to understand patterns and predictors of aggressive behaviour in young people admitted to an in-patient psychiatric unit.
Methods:
All patients admitted to the Mater Child & Youth Mental Health Service Inpatient Unit between October 2004 and December 2005 were monitored for aggressive behaviours. Incidents were documented prospectively by clinical staff. Documentation incorporated nature of the incident, time, location and response. Demographic and clinical characteristics were collected from charts for all patients.
Results:
During this time, 377 incidents were documented involving 40 patients (range 1–88 incidents per patient). About 23% of admissions were associated with aggressive behaviour. Thirty-six per cent of incidents involved violence toward staff. Compared with nonaggressive patients, aggressive patients were younger (P < 0.001), were more likely to be men (P < 0.01), have a history ofaggression (P < 0.05) and were be more likely to be receiving psychotropic medications at admission (P < 0.001). Aggression patients were more likely to have a diagnosis of mental retardation, pervasive development disorders and attention deficit hyperactivity disorder (ADHD), and less likely to have a mood disorder (P < 0.001).
Conclusions:
Young people most at risk of aggression appear to be younger men, with a diagnosis of mental retardation, development disorders or ADHD, and a history of aggressive behaviours. Further research is required to optimize prevention and management of these behaviours.
