THE RELATIONSHIP BETWEEN ACUTE PSYCHIATRIC-SYMPTOMS, DIAGNOSIS, AND SHORT-TERM RISK OF VIOLENCE

Objective: Previous research on violence and mental disorder has typic ally focused on the relationship between diagnosis and risk of violenc e or between symptoms within a particular diagnostic category and risk of violence. The authors' goal was to evaluate whether the pattern of symptoms associated with short-term risk! of violence varies dependin g on patients' diagnoses. Methods: Subjects were 330 patients with a v ariety of diagnoses who were hospitalized on a university-based, locke d psychiatric inpatient unit. At hospital ad mission, physicians rated patients' symptoms using the Brief Psychiatric Rating Scale. Nurses r ated whether patients became violent during hospitalization by complet ing the Overt Aggression Scale at the end of each shift. Results: Assa ultive patients had different symptom patterns than nonassaultive pati ents. Symptoms patterns varied significantly across diagnostic groups, and the symptom patterns associated with violence also varied signifi cantly across diagnostic groups. Higher levels of hostile-suspiciousne ss, agitation-excitement, and thinking disturbance were generally asso ciated with violence, although these symptoms were less Predictive of assaultiveness among schizophrenic patients than among patients in oth er diagnostic groups. Conclusions: Symptom profiles represent a useful level of analysis for understanding the relationship between violence and psychopathology, However the value of particular symptom profiles as indicators of imminent violence varies with diagnosis.