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Forms of Violent Behavior in Patients with Mental Disorders at the University Psychiatric Clinic Ljubljana from 2018 to 2021 Using the OAS/BVC Scale Assessment—A Descriptive Study Cover

Forms of Violent Behavior in Patients with Mental Disorders at the University Psychiatric Clinic Ljubljana from 2018 to 2021 Using the OAS/BVC Scale Assessment—A Descriptive Study

Open Access
|Sep 2026

References

  1. Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al. Prevalence of workplace violence against healthcare workers: A systematic review and meta-analysis. Occup Environ Med. 2019 Dec;76(12):927–937. doi: 10.1136/oemed-2019-105849.
  2. Babiarczyk B, Turbiarz A, Tomagová M, Zeleníková R, Önler E, Sancho Cantus D. Reporting of workplace violence towards nurses in 5 European countries - a cross-sectional study. Int J Occup Med Environ Health. 2020 Apr 30;33(3):325–338. doi: 10.13075/ijomeh.1896.01475.
  3. d'Ettorre G, Pellicani V. Workplace violence toward mental healthcare workers employed in psychiatric wards. Saf Health Work. 2017 Dec 1;8(4):337–42. doi: 10.1016/j.shaw.2017.01.004.
  4. Bellman V, Thai D, Chinthalapally A, Russell N, Saleem S, Bellman V, et al. Inpatient violence in a psychiatric hospital in the middle of the pandemic: Clinical and community health aspects. AIMSPH. 2022;9(2):342–356. doi: 10.3934/publichealth.2022024.
  5. Foster C, Bowers L, Nijman H. Aggressive behaviour on acute psychiatric wards: Prevalence, severity and management. J Adv Nurs. 2007;58(2):140–149. doi: 10.1111/j.1365-2648.2007.04169.x.
  6. Cornaggia CM, Beghi M, Pavone F, Barale F. Aggression in psychiatry wards: A systematic review. Psychiatry Res. 2011 Aug 30;189(1):10–20. doi: 10.1016/j.psychres.2010.12.024.
  7. Girasek H, Nagy VA, Fekete S, Ungvari GS, Gazdag G. Prevalence and correlates of aggressive behavior in psychiatric inpatient populations. World J Psychiatry. 2022 Jan 19;12(1):1–23. doi: 10.5498/wjp.v12.i1.1.
  8. Kayongo B, Rukundo GZ, Favina A, Maling S. Prevalence of aggression and associated factors among inpatients with mental illness at tertiary hospitals in Southwestern Uganda. BMC Psychiatry. 2025 Apr 23;25(1):417. doi: 10.1186/s12888-025-06865-6.
  9. Pelto-Piri V, Warg LE, Kjellin L. Violence and aggression in psychiatric inpatient care in Sweden: A critical incident technique analysis of staff descriptions. BMC Health Serv Res. 2020 Apr 26;20(1):362. doi: 10.1186/s12913-020-05239-w.
  10. Schlup N, Gehri B, Simon M. Prevalence and severity of verbal, physical, and sexual inpatient violence against nurses in Swiss psychiatric hospitals and associated nurse-related characteristics: Cross-sectional multicentre study. Int J Ment Health Nurs. 2021 Dec;30(6):1550–1563. doi: 10.1111/inm.12905.
  11. Weltens I, Bak M, Verhagen S, Vandenberk E, Domen P, van Amelsvoort T, et al. Aggression on the psychiatric ward: Prevalence and risk factors: A systematic review of the literature. PLoS One. 2021;16(10):e0258346. doi: 10.1371/journal.pone.0258346.
  12. Derks JL, Vermeulen JM, Boyette LL, Waldorp LJ, de Haan L. Short-term sequences of aggressive behavior in psychiatric inpatients with psychotic disorders using Markov models. J Ment Health. 2024 Mar 3;33(2):193–201. doi: 10.1080/09638237.2020.1818188.
  13. Jaspers A, Stringer B, Koch K, Kool N. [Self-harming behavior of patients on a closed psychiatric ward]. Tijdschr Psychiatr. 2023;65(4):244–247.
  14. Madsen T, Erlangsen A, Nordentoft M. Risk estimates and risk factors related to psychiatric inpatient suicide - an overview. Int J Environ Res Public Health. 2017 Mar 2;14(3):253. doi: 10.3390/ijerph14030253.
  15. Bernaldo-De-Quirós M, Piccini AT, Gómez MM, Cerdeira JC. Psychological consequences of aggression in pre-hospital emergency care: Cross sectional survey. Int J Nurs Stud. 2015 Jan;52(1):260–270. doi: 10.1016/j.ijnurstu.2014.05.011.
  16. Zerach G, Shalev TBI. The relations between violence exposure, posttraumatic stress symptoms, secondary traumatization, vicarious post traumatic growth and illness attribution among psychiatric nurses. Arch Psychiatr Nurs. 2015 Jun;29(3):135–142. doi: 10.1016/j.apnu.2015.01.002.
  17. Schablon A, Wendeler D, Kozak A, Nienhaus A, Steinke S. Prevalence and consequences of aggression and violence towards nursing and care staff in Germany - a survey. Int J Environ Res Public Health. 2018 Jun 15;15(6):1274. doi: 10.3390/ijerph15061274.
  18. Somani R, Muntaner C, Hillan E, Velonis AJ, Smith P. Effectiveness of interventions to de-escalate workplace violence against nurses in healthcare settings: A systematic review. Saf Health Work. 2021 Sep;12(3):289–295. doi: 10.1016/j.shaw.2021.04.004.
  19. Lickiewicz J, Adamczyk N, Hughes PP, Jagielski P, Stawarz B, Makara-Studzińska M. Reducing aggression in psychiatric wards using Safewards - a Polish study. Perspect Psychiatr Care. 2021 Jan;57(1):50–55. doi: 10.1111/ppc.12523.
  20. Gaynes BN, Brown CL, Lux LJ, Brownley KA, Van Dorn RA, Edlund MJ, et al. Preventing and de-escalating aggressive behavior among adult psychiatric patients: A systematic review of the evidence. Psychiatr Serv. 2017 Aug 1;68(8):819–831. doi: 10.1176/appi.ps.201600314.
  21. Maguire T, Daffern M, Bowe SJ, McKenna B. Risk assessment and subsequent nursing interventions in a forensic mental health inpatient setting: Associations and impact on aggressive behaviour. J Clin Nurs. 2018 Mar;27(5–6):e971–e983. doi: 10.1111/jocn.14107.
  22. Välimäki M, Lantta T, Kontio R. Risk assessment for aggressive behaviour in schizophrenia. Cochrane Database Syst Rev. 2024 May 2;5(5):CD012397. doi: 10.1002/14651858.CD012397.pub2.
  23. Yudofsky SC, Silver JM, Jackson W, Endicott J, Williams D. The Overt Aggression Scale for the objective rating of verbal and physical aggression. Am J Psychiatry. 1986 Jan;143(1):35–39. doi: 10.1176/ajp.143.1.35.
  24. Silver JM, Yudofsky SC. The Overt Aggression Scale: Overview and guiding principles. J Neuropsychiatry Clin Neurosci. 1991;3(2):S22–S29.
  25. Linaker OM, Busch-Iversen H. Predictors of imminent violence in psychiatric inpatients. Acta Psychiatr Scand. 1995 Oct;92(4):250–254. doi: 10.1111/j.1600-0447.1995.tb09578.x.
  26. Woods P, Almvik R. The Brøset violence checklist (BVC). Acta Psychiatrica Scandinavica. 2002;106(s412):103–105. doi: 10.1034/j.1600-0447.106.s412.22.x.
  27. Hatze R, Šikić Pogačar M, Peterka Novak J, Bregar B. Dataset for the article “Forms of violent behavior in patients with mental disorders at the University Psychiatric Clinic Ljubljana from 2018 to 2021 using the OAS/BVC scale assessment - a descriptive study” [Internet]. Geneva: Zenodo; 2026 [cited 2026 Jun 12]. Available at: https://zenodo.org/records/20642670
  28. Čelofiga A, Koprivšek J, Gregorič Kumperščak H, Kores Plesničar B. Incidence, severity and characteristics of patients' aggression in acute psychiatric wards: Data from a Slovenian national survey. Zdr Varst. 2023 Dec;62(4):190–197. doi: 10.2478/sjph-2023-0027.
  29. Kerr K, Oram J, Tinson H, Shum D. Health care workers' experiences of aggression. Arch Psychiatr Nurs. 2017 Oct;31(5):457–462. doi: 10.1016/j.apnu.2017.06.011.
  30. Yang Y, Li Y, An Y, Zhao YJ, Zhang L, Cheung T, et al. Workplace violence against Chinese frontline clinicians during the COVID-19 pandemic and its associations with demographic and clinical characteristics and quality of life: A structural equation modeling investigation. Front Psychiatry. 2021;12:649989. doi: 10.3389/fpsyt.2021.649989.
  31. Varghese A, Khakha DC, Chadda RK. Pattern and type of aggressive behavior in patients with severe mental illness as perceived by the caregivers and the coping strategies used by them in a tertiary care hospital. Arch Psychiatr Nurs. 2016 Feb;30(1):62–69. doi: 10.1016/j.apnu.2015.10.002.
  32. Knezevic V, Mitrovic D, Drezgic-Vukic S, Knezevic J, Ivezic A, Siladji-Mladenovic D, et al. Prevalence and correlates of aggression and hostility in hospitalized schizophrenic patients. J Interpers Violence. 2017 Jan;32(2):151–163. doi: 10.1177/0886260515585537.
  33. Araya T, Ebnemelek E, Getachew R. Prevalence and associated factors of aggressive behavior among patients with schizophrenia at Ayder Comprehensive Specialized Hospital, Ethiopia. Biomed Res Int. 2020;2020:7571939. doi: 10.1155/2020/7571939.
  34. Dack C, Ross J, Papadopoulos C, Stewart D, Bowers L. A review and meta-analysis of the patient factors associated with psychiatric in-patient aggression. Acta Psychiatr Scand. 2013 Apr;127(4):255–268. doi: 10.1111/acps.12053.
  35. Peluola A, Mela M, Adelugba OO. A review of violent incidents in a multilevel secure forensic psychiatric hospital: Is there a seasonal variation? Med Sci Law. 2013 Apr;53(2):72–79. doi: 10.1258/msl.2012.012016
  36. Berardelli I, Aguglia A, Amerio A, Sarubbi S, Rogante E, Trocchia MA, et al. Characterization of psychiatric inpatients: The role of gender differences in clinical and pharmacological patterns. J Psychiatr Pract. 2024 Jan;30(1):2. doi: 10.1097/PRA.0000000000000756.
  37. McQuaid RJ, Nikolitch K, Vandeloo KL, Burhunduli P, Phillips JL. Sex differences in determinants of suicide risk preceding psychiatric admission: An electronic medical record study. Front Psychiatry. 2022;13:892225. doi: 10.3389/fpsyt.2022.892225.
  38. Hu FH, Jia YJ, Zhao DY, Fu XL, Zhang WQ, Tang W, et al. Gender differences in suicide among patients with bipolar disorder: A systematic review and meta-analysis. J Affect Disord. 2023 Oct 15;339:601–614. doi: 10.1016/j.jad.2023.07.060.
  39. Toro GVR, Arias P, de la Torre-Luque A, Singer JB, Lagunas N. Depression, anxiety, and suicide among adolescents: Sex differences and future perspectives. J Clin Med. 2025 May 15;14(10):3446. doi: 10.3390/jcm14103446.
  40. Caruso R, Antenora F, Riba M, Belvederi Murri M, Biancosino B, Zerbinati L, et al. Aggressive behavior and psychiatric inpatients: A narrative review of the literature with a focus on the European experience. Curr Psychiatry Rep. 2021 Apr 7;23(5):29. doi: 10.1007/s11920-021-01233-z.
  41. Parakkal Kurian L, Rentala S, Belsiyal CX, Srinivasan P, Govindar Thimmajja S. Aggressive behavior and its associated factors among persons with mental illness: An observational study. J Educ Health Promot. 2023;12:249. doi: 10.4103/jehp.jehp_195_23.
  42. Font Pujol J, Gras ME, Calvó-Perxas L, Vilalta-Franch J. Scale for the Evaluation of Risk of Aggressiveness in psychiatric intensive care units. Actas Esp Psiquiatr. 2020 Jan;48(1):8–18.
  43. Lockertsen Ø, Varvin S, Færden A, Vatnar SKB. Short-term risk assessments in an acute psychiatric inpatient setting: A re-examination of the Brøset Violence Checklist using repeated measurements - differentiating violence characteristics and gender. Arch Psychiatr Nurs. 2021 Feb;35(1):17–26. doi: 10.1016/j.apnu.2020.11.003.
  44. Bader S, Evans SE, Welsh E. Aggression among psychiatric inpatients: The relationship between time, place, victims, and severity ratings. J Am Psychiatr Nurses Assoc. 2014 May;20(3):179–186. doi: 10.1177/1078390314537377.
  45. James K, Stewart D, Bowers L. Self-harm and attempted suicide within inpatient psychiatric services: A review of the Literature. Int J Ment Health Nurs. 2012;21(4):301–309. doi: 10.1111/j.1447-0349.2011.00794.x.
  46. Nawaz RF, Reen G, Bloodworth N, Maughan D, Vincent C. Interventions to reduce self-harm on in-patient wards: systematic review. BJPsych open. 2021 May;7(3):e80. doi: 10.1192/bjo.2021.41.
  47. Schneeberger AR, Kowalinski E, Fröhlich D, Schröder K, von Felten S, Zinkler M, et al. Aggression and violence in psychiatric hospitals with and without open door policies: A 15-year naturalistic observational study. J Psychiatr Res. 2017 Dec 1;95:189–195. doi: 10.1016/j.jpsychires.2017.08.017.
  48. Du M, Wang X, Yin S, Shu W, Hao R, Zhao S, et al. De-escalation techniques for psychosis-induced aggression or agitation. Cochrane Database Syst Rev. 2017 Apr 3;4(4):CD009922. doi: 10.1002/14651858.CD009922.pub2.
  49. Choi SW, Tran DHD. Heart attacks prevent chocolate: or the differences between correlation and causation. Anaesthesia. 2016 May;71(5):586–589. doi: 10.1111/anae.13402.
  50. Abderhalden C, Needham I, Dassen T, Halfens R, Haug HJ, Fischer JE. Structured risk assessment and violence in acute psychiatric wards: Randomised controlled trial. Brit J Psychiatry. 2008 Jul;193(1):44–50. doi: 10.1192/bjp.bp.107.045534.
  51. Hvidhjelm J, Berring LL, Whittington R, Woods P, Bak J, Almvik R. Short-term risk assessment in the long term: A scoping review and meta-analysis of the Brøset Violence Checklist. J Psychiatr Ment Health Nurs. 2023;30(4):637–648. doi: 10.1111/jpm.12905.
  52. Celofiga A, Kores Plesnicar B, Koprivsek J, Moskon M, Benkovic D, Gregoric Kumperscak H. Effectiveness of de-escalation in reducing aggression and coercion in acute psychiatric units. A cluster randomized study. Front Psychiatry. 2022;13:856153. doi: 10.3389/fpsyt.2022.856153.
  53. Bregar B, Skela-Savič B, Kores Plesničar B. Cross-sectional study on nurses' attitudes regarding coercive measures: The importance of socio-demographic characteristics, job satisfaction, and strategies for coping with stress. BMC Psychiatry. 2018 Jun 4;18(1):171. doi: 10.1186/s12888-018-1756-1.
  54. Espinosa L, Harris B, Frank J, Armstrong-Muth J, Brous E, Moran J, et al. Milieu improvement in psychiatry using evidence-based practices: The long and winding road of culture change. Arch Psychiatric Nurs. 2015 Aug;29(4):202–207. doi: 10.1016/j.apnu.2014.08.004.
DOI: https://doi.org/10.2478/sjph-2026-0021 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026
Language: English, Polish, Slovenian
Page range: 175 - 183
Submitted on: Jan 21, 2026
Accepted on: Jun 29, 2026
Published on: Sep 1, 2026
Published by: National Institute of Public Health, Slovenia
In partnership with: Paradigm Publishing Services

© 2026 Rok Hatze, Maja Šikić Pogačar, Jožica Peterka Novak, Branko Bregar, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution 4.0 License.