Physical aggression during admission to a child and adolescent inpatient unit: Predictors and impact on clinical outcomes

Dean, Angela J., Duke, Suzanne G., Scott, James, Bor, William, George, Michelle and McDermott, Brett M. (2008) Physical aggression during admission to a child and adolescent inpatient unit: Predictors and impact on clinical outcomes. Australian and New Zealand Journal of Psychiatry, 42 6: 536-543. doi:10.1080/00048670802050587


Author Dean, Angela J.
Duke, Suzanne G.
Scott, James
Bor, William
George, Michelle
McDermott, Brett M.
Title Physical aggression during admission to a child and adolescent inpatient unit: Predictors and impact on clinical outcomes
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
Publication date 2008-01-01
Year available 2008
Sub-type Article (original research)
DOI 10.1080/00048670802050587
Volume 42
Issue 6
Start page 536
End page 543
Total pages 8
Editor P. Joyce
Place of publication Abingdon, U.K.
Publisher Informa Healthcare
Language eng
Subject C1
110319 Psychiatry (incl. Psychotherapy)
920209 Mental Health Services
1103 Clinical Sciences
Formatted abstract
Objective: Aggressive behaviour is common in young people admitted to child and adolescent inpatient services. Little is known about how physical aggression during admission influences patient outcomes. The aim of the present study was to identify predictors of aggression in a child and adolescent inpatient unit and examine differences in clinical outcomes between aggressive and non-aggressive patients.
Method: Episodes of aggression occurring within a child and adolescent inpatient unit were prospectively documented between October 2004 and December 2005. Patient factors (demographics, diagnoses, clinical history) were examined as predictors of aggression. Outcomes for admissions in which more than one episode of physical aggression occurred were compared to those in which no aggression occurred. Outcomes assessed were changes in symptom severity (as rated by the Health of the Nation Outcome Scales for Children and Adolescents) length of stay, and initiation of medications.
Results: A total of 134 patients were admitted during the study period (61.9% female, mean age_13.8 years, SD_2.9); 31 patients (23.1%) exhibited physical aggression during admission and 20 of these exhibited more than one episode of physical aggression. Factors that predicted persistent physical aggression included history of aggression, use of medications at presentation and absence of self-harm. Persistent aggression was also associated with increased length of stay, but did not compromise improvements in clinical symptom ratings between admission and discharge or lead to increased medication prescribing.
Conclusion: Contrary to hypotheses and existing research, aggression during admission does not appear to be a barrier to clinical improvement. Further research is necessary to clarify how aggressive children can receive the most benefit from inpatient admission while minimizing the risks to the patient and those around them.

Keyword Aggression
Child behaviour disorders
Inpatients
Mental health services
Treatment outcome
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 24 Mar 2009, 21:32:41 EST by Sheila Cleary on behalf of Psychiatry - Royal Brisbane and Women's Hospital