ABSTRACT
BACKGROUND: In order to identify psychiatric patients who have a higher risk of being aggressive towards others, a risk checklist, the "Bremen Risk Assessment Scale for General Psychiatry" (BRAS-GP) was developed. The results of the first trial are described in this article. METHODS: In this prospective study all in-patients who were treated in the last quarter of 2006 were included. The BRAS-GP was applied on discharge to patients who were treated involuntarily. In a 1-year follow-up all patients who had been readmitted were analyzed to assess if any aggressive incident had occurred to confirm or refute the prognoses. RESULTS: On evaluation of the readmissions data, we calculated sensitivity of 0.72 and specificity of 0.71 as well as an "area under the curve" of 0.74. Especially during the first months after discharge readmissions linked with aggressive behavior were observed. CONCLUSION: The BRAS-GP is a useful prognostic instrument with high predictive validity. It can be easily applied in general psychiatric wards to help identify risk patients. After detecting risk patients special treatment strategies can then be offered.
Subject(s)
Hospitals, Psychiatric/statistics & numerical data , Mentally Ill Persons/psychology , Mentally Ill Persons/statistics & numerical data , Patient Discharge/statistics & numerical data , Psychometrics/methods , Violence/psychology , Violence/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Female , Forensic Psychiatry/methods , Germany/epidemiology , Humans , Incidence , Male , Middle Aged , Risk Assessment/methods , Risk Factors , Violence/prevention & control , Young AdultABSTRACT
A radioimmunoassay (RIA) procedure has been developed for the measurement of 5 alpha-pregnane-3,20-dione (DHP) in human plasma after ether extraction of the plasma-samples, followed by column chromatography. The antiserum was generated in rabbits with 6 alpha-carboxyethylmer-captoprogesterone-BSA conjugate. The high affinity (Ka = 3.72 X 10(9) l/mol) antiserum binds 40% of 40 picograms of tritiated 5 alpha-pregnane-3,20-dione at working dilutions of 1 : 2800. Negligible cross-reactivity of the antiserum was detected with 5 beta-pregnane-3,20-dione (1.8%). Other hydroxylated pregnanes showed minor cross-reactivity (5-40%). The cross-reacting steroids were all separated from pregnanedione by one chromatographic step. The plasma levels of 5 alpha-pregnane-3,20-dione were measured from 22nd to 42nd week of normal pregnancy and compared to published data.
