Giovanni de Girolamo1, Chiara Buizza2, Davide Sisti3, Clarissa Ferrari4, Viola Bulgari5, Laura Iozzino6, Maria Elena Boero7, Giuseppe Cristiano8, Alessandra De Francesco7, Gian Marco Giobbio9, Paolo Maggi10, Giuseppe Rossi11, Beatrice Segalini8, Valentina Candini12. 1. Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy. 2. Department of Clinical and Experimental Sciences, University of Brescia, Italy. 3. Institute of Biomathematics, University of Urbino, Italy. 4. Service of Statistics, Saint John of God Clinical Research Center, Brescia, Italy. 5. Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy; PhD School in Psychology, Catholic University of the Sacred Heart, Milan, Italy. 6. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy. 7. Rehabilitation Hospital Beata Vergine Della Consolata, Torino, Italy. 8. Villa Sant'Ambrogio Hospital, Milan, Italy. 9. Villa Sant'Ambrogio Hospital, Milan, Italy; Sacro Cuore di Gesù Center, Milan, Italy. 10. Sacro Cuore di Gesù Center, Milan, Italy. 11. Psychiatric Unit, Saint John of God Clinical Research Center, Brescia, Italy. 12. Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy; Department of General Psychology, University of Padova, Italy. Electronic address: vcandini@fatebenefratelli.eu.
Abstract
BACKGROUND: Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. AIMS: To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. METHODS: In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. RESULTS: The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. CONCLUSIONS: Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.
BACKGROUND: Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. AIMS: To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. METHODS: In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. RESULTS: The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. CONCLUSIONS:Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.
Authors: Stefano Barlati; Alberto Stefana; Francesco Bartoli; Giorgio Bianconi; Viola Bulgari; Valentina Candini; Giuseppe Carrà; Cesare Cavalera; Massimo Clerici; Marta Cricelli; Maria Teresa Ferla; Clarissa Ferrari; Laura Iozzino; Ambra Macis; Antonio Vita; Giovanni de Girolamo Journal: PLoS One Date: 2019-04-16 Impact factor: 3.240
Authors: E di Giacomo; A Stefana; V Candini; G Bianconi; L Canal; M Clerici; G Conte; M T Ferla; L Iozzino; G Sbravati; G Tura; R Micciolo; G de Girolamo Journal: Int J Neuropsychopharmacol Date: 2020-05-27 Impact factor: 5.176
Authors: Chiara Buizza; Cosmo Strozza; Giulio Sbravati; Giovanni de Girolamo; Clarissa Ferrari; Laura Iozzino; Ambra Macis; Harry G Kennedy; Valentina Candini Journal: Ann Gen Psychiatry Date: 2022-09-10 Impact factor: 3.301
Authors: Valentina Candini; Marta Ghisi; Giorgio Bianconi; Viola Bulgari; Antonino Carcione; Cesare Cavalera; Giovanni Conte; Marta Cricelli; Maria Teresa Ferla; Clarissa Ferrari; Laura Iozzino; Ambra Macis; Giuseppe Nicolò; Alberto Stefana; Giovanni de Girolamo Journal: Ann Gen Psychiatry Date: 2020-06-03 Impact factor: 3.455