Scale for the Evaluation of Risk of Aggressiveness in Psychiatric Intensive Care Units.

INTRODUCTION: The multifactorial origin of violent behaviors generates the need to use prediction tools adapted to different contexts, patient profiles and types of aggression. The main objective of this work was to design an instrument to detect the risk of violence and aggression quickly and effectively in patients with mental disorder in psychiatric intensive care units. MATERIAL AND METHODS: The sample consisted of 722 admissions of 629 patients from the psychiatric intensive care units. Violent incidents were recorded using the Overt Aggression Scale (OAS). A new scale has been designed and its psychometric properties have been evaluated. RESULTS: The Scale for the Evaluation of Risk of Aggressiveness (ERA) includes static and dynamic risk factors, has an AUC=0.854, a sensitivity of 82%, a specificity of 73%, a positive predictive value of 62% and a negative predictive value of 88% when the cut-off point of ¾ is used to determine the risk of violent or aggressive behavior. CONCLUSIONS: The ERA has proven to be a valid and reliable instrument to forecast the risk of aggressiveness in patients admitted to an acute care unit of psychiatry. It also allows monitoring and updating this risk during the patient's stay in the psychiatric intensive care unit.

Escala para la Evaluación del Riesgo de Agresividad en una Unidad de Agudos de Psiquatría / Scale for the Evaluation of Risk of Aggressiveness in Psychiatric Intensive Care Units

INTRODUCCIÓN: El origen multifactorial de la agresividad y la violencia genera la necesidad de utilizar instrumentos de predicción adaptados a diferentes contextos, perfiles de pacientes y tipos de agresividad. El principal objetivo de este trabajo fue diseñar un instrumento para detectar el riesgo de violencia y agresividad de forma rápida y eficaz en pacientes con trastorno mental en unidades de agudos de psiquiatría. MATERIAL Y MÉTODOS: La muestra consistió en 722 ingresos de 629 pacientes de la Unidad de Agudos. Los incidentes de violencia y agresividad fueron registrados usando la Overt Aggression Scale (OAS). Se ha diseñado una nueva escala y se han evaluado sus propiedades psicométricas. RESULTADOS: La Escala para la Evaluación del Riesgo de Agresividad (ERA) incluye factores de riesgo estáticos y dinámicos, tiene un AUC=0.854, una sensibilidad del 82%, una especificidad del 73%, un valor predictivo positivo del 62% y un valor predictivo negativo de 88% cuando se utiliza el punto de corte ¾ para determinar el riesgo de comportamiento violento o agresivo. CONCLUSIONES: La ERA ha demostrado ser un instrumento válido y fiable, eficaz para predecir el riesgo de agresividad en los pacientes ingresados en una unidad de agudos de psiquiatría. También permite hacer un seguimiento y actualizar este riesgo durante la estancia del paciente en la unidad de agudos

INTRODUCTION: The multifactorial origin of violent behaviors generates the need to use prediction tools adapted to different contexts, patient profiles and types of aggression. The main objective of this work was to design an instrument to detect the risk of violence and aggression quickly and effectively in patients with mental disorder in psychiatric intensive care units. MATERIAL AND METHODS: The sample consisted of 722 admissions of 629 patients from the psychiatric intensive care units. Violent incidents were recorded using the Overt Ag-gression Scale (OAS). A new scale has been designed and its psychometric properties have been evaluated. RESULTS: The Scale for the Evaluation of Risk of Aggressiveness (ERA) includes static and dynamic risk factors, has an AUC=0.854, a sensitivity of 82%, a specificity of 73%, a positive predictive value of 62% and a negative predictive value of 88% when the cut-off point of ¾ is used to determine the risk of violent or aggressive behavior. CONCLUSIONS: The ERA has proven to be a valid and reliable instrument to forecast the risk of aggressiveness in patients admitted to an acute care unit of psychiatry. It also allows monitoring and updating this risk during the patient's stay in the psychiatric intensive care unit

Types of Polydrug Use Among Spanish Students in Health Sciences.

Polydrug use among university students may be a predictor for established patterns of multiple substance use and potentially entail long-term health problems. This study examined the types of polydrug use among Spanish students in health sciences. Undergraduate students (n = 968), aged 18-38 years (M = 21.09 years, SD = 4.10), completed the survey. A percentage of 44.3% of the participants were classified as polydrug users. Type A users (alcohol and cigarettes) made up 17.8% of the participants surveyed, whereas 20.1% were Type B (cannabis with cigarettes and/or alcohol), and a further 5.7% were Type C (cannabis with cigarettes and/or alcohol, plus at least another kind of illegal drug). Type A was the most common type among women, whereas Type C was the most common among men. Type B use was higher among women 18-19 years old than among women 25-29 years old, whereas there were no female Type C users younger than 20 years old. Weekend consumption was higher, than weekday consumption, across all polydrug user types and substances. These results suggest that the prevalence of polydrug use among Spanish students in health sciences was similar to students in other disciplines, with Type B as the most prevalent among healthcare and nonhealthcare students. Taking into account the differences based on gender, age, and time of consumption, a specific approach to the different typologies of polydrug users might be a vital step in the successful development of preventive interventions tailored to the changing reality of psychoactive substance use.

Concurrent and Simultaneous Use of Cannabis and Tobacco and Its Relationship with Academic Achievement amongst University Students.

The combined use of cannabis and tobacco is frequent in Europe. Few studies have nonetheless explored this pattern of consumption and its relationship with academic achievement in Spanish population. The aim of the present study was to analyze (1) the frequency of four patterns of polydrug use the last year (non-dual users of cannabis and tobacco; concurrent users: cannabis and tobacco separately; simultaneous users: tobacco in cannabis "joints"; simultaneous users: tobacco in cannabis joints alongside alcohol) by gender and age; (2) grade point average (GPA) by gender and age; (3) the association between the frequency of the four patterns of use and the GPA amongst a sample of 477 Spanish university students. The use of cannabis and tobacco (concurrent and simultaneous) and GPA were assessed by means of self-reported questionnaires. Statistically significant differences were found for the GPA with respect to gender. The GPA by the non-dual users of cannabis and tobacco was significantly higher than the GPA corresponding to the concurrent and simultaneous users. The combined use of cannabis and tobacco, regardless of the type of use (concurrent or simultaneous), is moderately related to poor academic achievement amongst university students.