Risk of violence of inpatients with severe mental illness – Do patients with schizophrenia pose harm to others?

• In the 4 index years 7222 patients were admitted to the Department of Psychiatry and Psychotherapy.
• The proportion of involuntary admissions increased from 6.2% in 1992 to 43.8% in 2007.
• The highest rates of involuntary admissions were observed in the group F0, F6, and F1 and F2.
• Risk of harm to others was more commonly seen in the groups F0, F2 and F6, as well as in F1.
• Patients of the group F0 showed the highest risk of being particularly difficult to manage.

Individuals suffering from schizophrenia are frequently considered to be dangerous. The current longitudinal chart review was carried out to investigate the diagnostic mix of patients who were admitted to the Department of Psychiatry and Psychotherapy at the Medical University Innsbruck due to risk of harm to others. The sample consisted of all adult inpatients admitted to psychiatric acute care units in the years 1992, 1997, 2002, and 2007. Data collection included diagnoses, criteria for risk of harm to others, and the use of mechanical restraint. Altogether, 7222 admissions were reviewed. Of these, 529 patients had to be admitted to a locked unit because of risk of harm to others. Among those mechanical restraint was more often used in patients with organic mental disorders, Cluster B personality disorders, and mania than in patients with schizophrenia. Patients suffering from schizophrenia with comorbid psychoactive substance use constitute a potentially harmful population and are therefore frequently admitted to locked units due to risk of harm to others. However, in the current study additional coercive measures were more commonly applied in patients suffering from personality disorders and organic mental disorders.