Management of the aggressive and dangerous patient.

Violence is the ultimate maladaptive coping behavior manifested by a small but significant number of psychiatric patients. The management of the aggressive and dangerous patient depends on recognition of predisposing developmental experiences, cognitive and behavioral factors, and situational circumstances that potentiate a violent outburst. The author presents management guidelines, which stem from an understanding of the paranoid process, respect for the limited coping skills of the individual, and appropriate use of verbal, physical, and chemical interventions.