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The First Step in the Validation of a new Screen for Violence Risk in Acute Psychiatry: The Inpatient Context

Published online by Cambridge University Press:  24 April 2010

P. Hartvig ,
J.O. Roaldset ,
T.A. Moger ,
B. Østberg  and
S. Bjørkly
P. Hartvig*
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway
J.O. Roaldset
Affiliation:
Psychiatric Department, Ålesund Hospital, N-6026Ålesund, Norway
T.A. Moger
Affiliation:
Department of Biostatistics, University of Oslo, P.O. Box 1122, N-0317 Oslo, Norway
B. Østberg
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway
S. Bjørkly
Affiliation:
Centre for Research and Education in Forensic Psychiatry, Ullevål University Hospital, Bygg 7, Gaustad, 0320 Oslo, Norway Institute of Health and Social Sciences, Molde University College, Norway, Box 2110, N-6402 Molde, Norway
*
⁎Corresponding author. Tel.: +47 22 02 92 20; fax: +47 22 02 92 21. E-mail address:paal.hartvig@kompetanse-senteret.no
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Abstract

Background

Instruments for evaluating the risk of violence towards others have mostly been developed for assessment of risk for recidivism into violent crime in forensic psychiatry. In general psychiatry there is a considerable need for specialised, brief and structured assessment tools to inform risk decisions.

Method

The study aimed to validate a brief structured clinical risk assessment screen of inpatient violence (V-RISK-10), a 10-item structured clinical checklist with a good vignette-based interrater reliability (ICC=0.87). In this study it was used for risk assessment of a one-year sample of patients (N = 1.017) admitted to two acute psychiatric units. Risk assessments at admission were compared to prospective records of aggressive and violent acts during the hospital stay.

Results

Results showed a base rate for aggression of 9%. The predictive validity of the V-RISK-10 was estimated by Receiver Operating Characteristics (ROC). It yielded an area under the curve (AUC) of 0.83, with sensitivity/specificity of 0.81/0.73 and corresponding positive and negative predictive values (PPV/NPV) of 0.24/0.97. The screen was easy-to-use and showed a short completion time.

Conclusion

Despite promising results further validation studies are required before the V-RISK-10 is adopted into routine clinical practise.

Keywords

Violence risk screeningAcute general psychiatry

Information

Type
Original article
Information
European Psychiatry , Volume 26 , Issue 2 , March 2011 , pp. 92 - 99
Copyright
Copyright © Elsevier Masson SAS 2010

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Footnotes

1

Tel.: +47 70 10 50 00; fax: +47 70 10 6554.

2

Tel.: +47 22 85 11 49; fax: +47 22 85 13 13.

3

Tel.: +47 71 21 40 12; fax: +47 71 21 40 50.

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