ArticleJournal of child and adolescent psychopharmacology2013
Frequency, characteristics and management of adolescent inpatient aggression.
Article in Journal of child and adolescent psychopharmacology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 61 citations in OpenAlex.
- Authorized Seclusion, Restraint, and Safeguards in Home and Community Based Medicaid Programs for Children With Serious Emotional Disturbance.Community mental health journal · 2026Article
- Factors associated with violent behavior among hospitalized adolescents with affective disorders: a two-center cross-sectional study.Frontiers in psychiatry · 2026Article
- Validity of nursing interventions for aggressive behavior in neurodevelopmental disorders in child and adolescent psychiatry: A modified e-Delphi study.PCN reports : psychiatry and clinical neurosciences · 2025Article
- Difficulties in providing nursing care to children with neurodevelopmental disorders admitted to child and adolescent psychiatric units for aggressive behavior.Japan journal of nursing science : JJNS · 2025Article
- Predictive accuracy of the Violence Risk Assessment Checklist for Youth in acute institutions: A prospective naturalistic multicenter study.European psychiatry : the journal of the Association of European Psychiatrists · 2025Observational
- Children and adolescents at risk for seclusion and restraint in inpatient psychiatric treatment: a case control study.Child and adolescent psychiatry and mental health · 2024Article
- Impact of a debrief tool in acute child and adolescent mental health inpatient units: a centre's experience.BMJ open quality · 2024Article
- Interrater reliability of the violence risk assessment checklist for youth: a case vignette study.BMC psychiatry · 2024Article
- Prevalence and correlates of restrictive interventions in an Irish child and adolescent psychiatric unit: a 4-year retrospective study.Irish journal of medical science · 2023Article
- Methods and Strategies for Reducing Seclusion and Restraint in Child and Adolescent Psychiatric Inpatient Care.The Psychiatric quarterly · 2022Review
- Elevated Rates of Restraint and Seclusion in Child and Adolescent Psychiatric Inpatients in China and Their Associated Factors.Child psychiatry and human development · 2021Article
- Patient Risk Factors for Violent Restraint Use in a Children's Hospital Medical Unit.Hospital pediatrics · 2021Article
- Physical restraint during inpatient treatment of adolescent anorexia nervosa: frequency, clinical correlates, and associations with outcome at five-year follow-up.Journal of eating disorders · 2020Article
- Factors Associated With Involuntary Psychiatric Hospitalization of Youths in China Based on a Nationally Representative Sample.Frontiers in psychiatry · 2020Article
- Mental health of the male adolescent and young man: the Copenhagen statement.World journal of pediatrics : WJP · 2018Review
- Stability and Change of Adolescents' Aggressive Behavior in Residential Youth Care.Child & youth care forum · 2018Article
- Characteristics of adolescents frequently restrained in acute psychiatric units in Norway: a nationwide study.Child and adolescent psychiatry and mental health · 2017Article
- Child Psychiatric Emergencies: Updates on Trends, Clinical Care, and Practice Challenges.Current psychiatry reports · 2016Review
- Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice.European child & adolescent psychiatry · 2014Article
- The use and effectiveness of pro re nata psychotropic medications in children and adolescents: A systematic review.Indian journal of psychiatryArticle
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInpatient aggression is a serious challenge in pediatric psychiatry.
methodsA chart review study in adolescent psychiatric inpatients consecutively admitted over 24 months was conducted, to describe aggressive events requiring an intervention (AERI) and to characterize their management. AERIs were identified based on specific institutional event forms and/or documentation of as-needed (STAT/PRN) medication administration for aggression, both recorded by nursing staff.
resultsAmong 408 adolescent inpatients (age: 15.2±1.6 years, 43.9% male), 1349 AERIs were recorded, with ≥1 AERI occurring in 28.4% (n=116; AERI+). However, the frequency of AERIs was highly skewed (median 4, range: 1-258). In a logistical regression model, the primary diagnosis at discharge of disruptive behavior disorders and bipolar disorders, history of previous inpatient treatment, length of hospitalization, and absence of a specific precipitant prior to admission were significantly associated with AERIs (R(2)=0.32; p<0.0001). The first line treatment of patients with AERIs (AERI+) was pharmacological in nature (95.6%). Seclusion or restraint (SRU) was used at least once in 59.4% of the AERI+ subgroup (i.e., in 16.9% of all patients; median within-group SRU frequency: 3). Treatment and discharge characteristics indicated a poorer prognosis in the AERI+ (discharge to residential care AERI+: 22.8%, AERI-: 5.6%, p<0.001) and a greater need for psychotropic polypharmacy (median number of psychotropic medications AERI+: 2; AERI-: 1, p<0.001).
conclusionsDespite high rates of pharmacological interventions, SRU continue to be used in adolescent inpatient care. As both of these approaches lack a clear evidence base, and as adolescents with clinically significant inpatient aggression have increased illness acuity/severity and service needs, structured research into the most appropriate inpatient aggression management is sorely needed.
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