Use of risk assessment instruments to predict violence in forensic psychiatric hospitals: a systematic review and meta-analysis

Publication date: August 2018Source: European Psychiatry, Volume 52Author(s): Taanvi Ramesh, Artemis Igoumenou, Maria Vazquez Montes, Seena FazelAbstractBackground and AimsViolent behaviour by forensic psychiatric inpatients is common. We aimed to systematically review the performance of structured risk assessment tools for violence in these settings.MethodsThe nine most commonly used violence risk assessment instruments used in psychiatric hospitals were examined. A systematic search of five databases (CINAHL, Embase, Global Health, PsycINFO and PubMed) was conducted to identify studies examining the predictive accuracy of these tools in forensic psychiatric inpatient settings. Risk assessment instruments were separated into those designed for imminent (within 24 hours) violence prediction and those designed for longer-term prediction. A range of accuracy measures and descriptive variables were extracted. A quality assessment was performed for each eligible study using the QUADAS-2. Summary performance measures (sensitivity, specificity, positive and negative predictive values, diagnostic odds ratio, and area under the curve value) and HSROC curves were produced. In addition, meta-regression analyses investigated study and sample effects on tool performance.ResultsFifty-two eligible publications were identified, of which 43 provided information on tool accuracy in the form of AUC statistics. These provided data on 78 individual samples, with information on 6,840 patients. ...

Source: European Psychiatry - July 11, 2018 Category: Psychiatry Source Type: research