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