Aggressive behaviour of psychiatric patients with mild and borderline intellectual disabilities in general mental health care.

Autor: Nieuwenhuis JG; Department VGGNet, Ggnet Mental Hospital, Warnsveld, Netherlands., Lepping P; Betsi Cadwaladr University Health Board, Wrexham, Wales, United Kingdom.; Mysore Medical College & Research Institute, Mysuru, India.; Department Centre for Mental Health and Society, Wrexham Academic Unit, Wrexham, United Kingdom., Mulder CL; Department Psychiatry, Cornelis Lambert Mulder Erasmus University Rotterdam, Rotterdam, Netherlands., Nijman HLI; Department Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.; Firvoor Forensic Hospital, Den Dolder, The Netherlands., Noorthoorn EO; Department Research and Development Vordenseweg Ggnet Mental Hospital, Warnsveld, Netherlands.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Oct 03; Vol. 17 (10), pp. e0272502. Date of Electronic Publication: 2022 Oct 03 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0272502
Abstrakt: Purpose: Little is known about the associations between mild intellectual disability (MID), borderline intellectual functioning (BIF) and aggressive behaviour in general mental health care. The study aims to establish the association between aggressive behaviour and MID/BIF, analysing patient characteristics and diagnoses.
Method: 1174 out of 1565 consecutive in-and outpatients were screened for MID/BIF with the Screener for Intelligence and Learning Disabilities (SCIL) in general mental health care in The Netherlands. During treatment, aggressive behaviour was assessed with the Staff Observation Aggression Scale-Revised (SOAS-R). We calculated odds ratios and performed a logistic and poisson regression to calculate the associations of MID/ BIF, patient characteristics and diagnoses with the probability of aggression.
Results: Forty-one percent of participating patients were screened positive for MID/BIF. Patients with assumed MID/BIF showed significantly more aggression at the patient and sample level (odds ratio (OR) of 2.50 for aggression and 2.52 for engaging in outwardly directed physical aggression). The proportion of patients engaging in 2-5 repeated aggression incidents was higher in assumed MID (OR = 3.01, 95% CI 1.82-4.95) and MID/BIF (OR = 4.20, 95% CI 2.45-7.22). Logistic regression showed that patients who screened positive for BIF (OR 2,0 95% CL 1.26-3.17), MID (OR 2.89, 95% CI 1.87-4.46), had a bipolar disorder (OR 3.07, 95% CI 1.79-5.28), schizophrenia (OR 2.75, 95% CI 1.80-4.19), and younger age (OR 1.69, 95% CI 1.15-2.50), were more likely to have engaged in any aggression. Poisson regression underlined these findings, showing a SCIL of 15 and below (β = 0.61, p<0.001) was related to more incidents.
Conclusions: We found an increased risk for aggression and physical aggression in patients with assumed MID/BIF. We recommend screening for intellectual functioning at the start of treatment and using measures to prevent and manage aggressive behaviour that fits patients with MID/BIF.
Competing Interests: One of the authors of this article (H. Nijman) is a (co-)author of both the aggression scale (SOAS-R) and the Screener for Intelligence and learning disabilities (SCIL) that were used to collect data in this study. The authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Databáze: MEDLINE
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