A Pilot Study to Calculate the sample size for the Prevalence of Aggression in Psychiatric Outpatient Setting.

Background: There is a rise in the number of invisible mental health problems like aggression in a developing country like India. There is scarce data available on the prevalence of aggression in psychiatric patients which has been collected in a systematic manner. Objective: A pilot study to calculate the sample size for the prevalence of aggression in psychiatric outpatient setting in a General Hospital Psychiatric Unit using Modified Overt Aggression Scale in twenty patients. Results: The prevalence of aggression was 20% in the pilot study. Conclusions: This pilot study enabled us to calculate the sample size accurately. This also facilitated the investigator to handle the shortcomings and modify the research protocol accordingly.

Predictors of Aggressive Behaviours in Drug De-Addiction Centre.

Aim: Associations have been reported between aggression and psychoactive substance use. This study aimed to assess the prevalence and nature of aggressive incidents and to examine the factors associated with aggression in patients in a drug de-addiction unit. Method: Forms of aggression and their severity were assessed based on questions of Overt Aggression Scale (OAS). Data were collected from inpatients about the nature of their aggressive incident during a 12-month period. The characteristics of those patients involved in aggressive incidents were compared with those of others who had not been aggressive. Results: Fifty out of 83 patients admitted during this period were involved in some form of aggressive behaviour. Pattern of aggressive behaviour exhibited by patients were in the form of verbal aggression 60.24% (N=50); Object aggression 28.9% (N=24); Aggression toward other 32.53% (N=27) and Aggression toward self 2.41% (N=2). There were high correlations of one form of aggression in presence of other forms. Most common diagnosis was alcohol dependence. On the whole aggression was found to be higher in the alcohol withdrawal with delirium group. While all other forms of violence showed increase with past histories, statistical significance was there only in aggression towards others (p=0.043). Aggressive behaviours generally reported less in voluntarily admitted patients. Comparison of aggressive behaviour in relation to family type, locality, religion, family history of violence did not yield any significant variation. Conclusion: Like weather forecasting, predictions of future violence will not always be correct. However, in order to prevent aggressive incidents, present study revealed that particular attention and increase support required in patients living in the nuclear family, unwilling for admission, past history of aggressive incidents and diagnoses of alcohol withdrawal. Verbal aggression could be considered as strong predictor for other type of assault.