Risk assessment of imminent violence in acute psychiatry : a step towards an extended model

Øyvind Lockertsen, Sverre Varvin, Ann Færden, Bjørn Magne Sundsbø Eriksen, John Olav Roaldset, Nicholas G. Procter, Solveig Karin Bø Vatnar

Vitenskapelig artikkel
Journal of Forensic Psychiatry & Psychology, 2019
Online / DOI:
Aggression occurs frequently in mental health care settings, and studies have reported that 17% to 31% of patients admitted to acute psychiatric wards commit violence. Inpatients’ fluctuating mental states and behaviour patterns reinforce the need for an assessment instrument to predict potential violence in a timely manner. This naturalistic prospective inpatient study investigated whether an extended short-term risk assessment model that combines (a) short-term risk assessment with the Broset Violence Checklist (BVC), (b) patient’s own prediction of violence with the Self-Report Risk Scale (SRS) and (c) single items from the Violence Risk Screening 10 (V-RISK-10) provides better short-term predictive accuracy for violence than the BVC alone. All patients admitted to a psychiatric emergency hospital in Norway during one year were included (N = 508). Stepwise multivariate generalised linear mixed model analyses were conducted. When adjusting for repeated measurements, the results indicated that an extended model for short-term risk assessment, consisting of the BVC, SRS and Item 2 Previous and/or current threats from the V-RISK-10 explained more variance of imminent violence, compared to the BVC alone. Further studies are recommended to investigate whether the extended model provides a clinically better short-term risk prediction of imminent violence, compared to the BVC alone. Keywords: acute psychiatry, aggression, repeated measurements, risk assessment, violence