[Bremen Risk Assessment Scale for General Psychiatry. Predicting violent behavior in mentally ill patients discharged from general psychiatry].

Der Nervenarzt
S von BergJ Timm

Abstract

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. 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. 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. 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.

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