Pharmacopsychiatry 2007; 40(1): 25-29
DOI: 10.1055/s-2007-961817
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Aggression of Psychiatric Patients Associated with the Use of As-needed Medication

L. E. Goedhard 1 , 2 , J. J. Stolker 1 , 2 , H. L. I. Nijman 3 , A. C. G. Egberts 2 , 4 , E. R. Heerdink 2
  • 1Altrecht Institute for Mental Health Care, Den Dolder, The Netherlands
  • 2Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands
  • 3Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands
  • 4Department of Clinical Pharmacy, University Medical Center Utrecht, The Netherlands
Further Information

Publication History

received 8. 8. 2006 revised 17. 11. 2006

accepted 15. 12. 2006

Publication Date:
27 February 2007 (online)

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Abstract

Introduction: Previous studies showed that aggression is an important reason to prescribe as-needed medication. The objective of this study was to compare the use of as-needed medication in aggressive and non-aggressive psychiatric patients and to explore patterns of administration of as-needed medication around aggressive incidents.

Methods: An observational study in three psychiatric wards was conducted. Incidence densities of as-needed medication were determined for aggressive and non-aggressive patients and expressed as incidence density ratios [IDRs]. Intensity of as-needed medication used before and following aggressive incidents were determined within a 48-hours time-window.

Results: Aggressive patients had an increased use of both psychotropic and somatic as-needed medication (IDR, 2.5; 95% CI, 2.2-2.7 and IDR, 2.1; 95% CI, 1.8-2.4, respectively). Of the psychotropic medication for aggressive patients, 15% was administered in a time-window of 48 hours around an aggressive incident; in this time-window more as-needed medication was administered following an aggressive incident compared to earlier treatments.

Conclusion: An increased use of both psychotropic and somatic as-needed medication is associated with aggressive behavior. Psychotropic as-needed medication is more frequently administered shortly after an aggressive incident than shortly before. However, more often as-needed medication is administered outside the 48 hours time-window around an aggressive incident.