{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:16:31Z","timestamp":1791357391257,"version":"4.3.1"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2015,5,4]],"date-time":"2015-05-04T00:00:00Z","timestamp":1430697600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CNS Spectr."],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec id=\"S1092852915000188_abs1\" sec-type=\"intro\"><jats:title>Introduction<\/jats:title><jats:p>We examined physical violence in a large, multihospital state psychiatric system during 2011\u20132013, and associated demographic and clinical characteristics of violent patients to better understand issues of patient and staff safety.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852915000188_abs2\" sec-type=\"general\"><jats:title>Method<\/jats:title><jats:p>Acts of physical violence committed by patients against other patients (n=10,958) or against staff (n=8429) during 2011\u20132013 were collected and analyzed for all hospitalized patients during the same time period to derive prevalence rates and associated odds ratios.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852915000188_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Overall, 31.4% of patients committed at least 1 violent assault during their hospitalization. Differential risk factor patterns were noted across patient and staff assault. Younger age was associated with a higher prevalence of both patient and staff assault, as was nonforensic legal status. Females had a higher prevalence of staff assault than patient assault. Ethnic groups varied on rates of patient assault, but had no significant differences for staff assault. Schizoaffective disorder was associated with higher prevalence and odds of patient (OR 1.244, 95% CI 1.131 to 1.370) and staff (OR 1.346, 95% CI 1.202 to 1.507) assault when compared to patients diagnosed with schizophrenia. Most personality disorder diagnoses also had a higher prevalence and odds of physical violence. One percent of patients accounted for 28.7% of all assaults. Additionally, violent patients had a significantly longer length of hospitalization.<\/jats:p><\/jats:sec><jats:sec id=\"S1092852915000188_abs4\" sec-type=\"discussion\"><jats:title>Discussion<\/jats:title><jats:p>Implications of these findings to enhance patient safety and inform future violence reduction efforts, including the need for new treatments in conjunction with the use of violence risk assessments, are discussed.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1092852915000188","type":"journal-article","created":{"date-parts":[[2015,5,22]],"date-time":"2015-05-22T11:35:34Z","timestamp":1432294534000},"page":"319-330","source":"Crossref","is-referenced-by-count":62,"title":["Prevalence of physical violence in a forensic psychiatric hospital system during 2011\u20132013: Patient assaults, staff assaults, and repeatedly violent patients"],"prefix":"10.1017","volume":"20","author":[{"given":"Charles","family":"Broderick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Azizian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Kornbluh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Warburton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,5,4]]},"reference":[{"key":"S1092852915000188_ref21","first-page":"175","article-title":"Incidents in hospitalized forensic patients","volume":"5","author":"Stokman","year":"1980","journal-title":"Victimology"},{"key":"S1092852915000188_ref8","doi-asserted-by":"publisher","DOI":"10.1176\/ps.50.11.1461"},{"key":"S1092852915000188_ref5","first-page":"1112","article-title":"Characteristicsof repeatedly assaultive psychiatric inpatients","volume":"41","author":"Convit","year":"1990","journal-title":"Hosp Community Psychiatry"},{"key":"S1092852915000188_ref19","first-page":"110","article-title":"The relationship of gender to violent behavior in acutely disturbed psychiatric patients","volume":"51","author":"Binder","year":"1990","journal-title":"J Clin Psychiatry"},{"key":"S1092852915000188_ref15","doi-asserted-by":"publisher","DOI":"10.1176\/ps.50.3.390"},{"key":"S1092852915000188_ref9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.1.75"},{"key":"S1092852915000188_ref6","doi-asserted-by":"publisher","DOI":"10.1177\/0886260504266883"},{"key":"S1092852915000188_ref14","volume-title":"The Vital Role of State Psychiatric Hospitals","author":"Parks","year":"2014"},{"key":"S1092852915000188_ref1","first-page":"101","volume-title":"Violence and Mental Disorder: Developments in Risk Assessment","author":"Swanson","year":"1994"},{"key":"S1092852915000188_ref3","article-title":"Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy","author":"Swanson","journal-title":"Ann Epidemiol"},{"key":"S1092852915000188_ref4","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1176\/ajp.145.8.965","article-title":"Predictors of violence in civilly committed acute psychiatric patients","volume":"145","author":"McNiel","year":"1988","journal-title":"Am J Psychiatry"},{"key":"S1092852915000188_ref27","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.045534"},{"key":"S1092852915000188_ref22","doi-asserted-by":"publisher","DOI":"10.3109\/01612849309010322"},{"key":"S1092852915000188_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1745-0179-3-30"},{"key":"S1092852915000188_ref10","doi-asserted-by":"publisher","DOI":"10.1186\/1745-0179-1-11"},{"key":"S1092852915000188_ref24","first-page":"829","article-title":"On the need for a closed ward in an open hospital: the psychiatric intensive-care unit","volume":"24","author":"Rachlin","year":"1973","journal-title":"Hosp Community Psychiatry"},{"key":"S1092852915000188_ref26","doi-asserted-by":"publisher","DOI":"10.1177\/0093854809347738"},{"key":"S1092852915000188_ref25","doi-asserted-by":"publisher","DOI":"10.1080\/000486700271"},{"key":"S1092852915000188_ref20","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780195138825.001.0001","volume-title":"Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence","author":"Monahan","year":"2001"},{"key":"S1092852915000188_ref13","volume-title":"Inpatient violence and aggression: a literature. 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