SynthesisPloS one2021
Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature.
Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
99 citing papers in PubMed, 4 syntheses or guidelines pooled it, 167 citations in OpenAlex.
- Post-incident debriefing for people with schizophrenia after coercive measures.The Cochrane database of systematic reviews · 2025Pooled it
- The Association Between Nurse Staffing and Conflict and Containment in Acute Mental Health Care: A Systematic Review.International journal of mental health nursing · 2025Pooled it
- Suicidal risk in patients with aggression in schizophrenia: a systematic review.Frontiers in psychiatry · 2025Pooled it
- Pooled it
- Targeting aggression with prefrontal high-definition transcranial direct current stimulation.Scientific reports · 2026Trial
- "Just (Don't) do It?" Stakeholder Perspectives on Physical Activity Interventions in Adult Acute Mental Health Wards: A Qualitative Thematic Analysis.International journal of mental health nursing · 2026Article
- Contributing Factors to Severe Workplace Violence in Forensic Psychiatry: A Longitudinal Retrospective Analysis of Incident Reports.Journal of psychiatric and mental health nursing · 2026Article
- Authorized Seclusion, Restraint, and Safeguards in Home and Community Based Medicaid Programs for Children With Serious Emotional Disturbance.Community mental health journal · 2026Article
- Article
- Forms of Violent Behavior in Patients with Mental Disorders at the University Psychiatric Clinic Ljubljana from 2018 to 2021 Using the OAS/BVC Scale Assessment-A Descriptive Study.Zdravstveno varstvo · 2026Article
- Actual status of visitor and telephone restrictions for Japanese psychiatric inpatients: A retrospective observational study.PCN reports : psychiatry and clinical neurosciences · 2026Article
- Workplace Violence Prevention in Forensic Psychiatric Nursing: A Five-Year Qualitative Content Analysis of Incident Reports From a Finnish Forensic Psychiatric Hospital.Journal of psychiatric and mental health nursing · 2026Article
- Triggers, Responses, and Outcomes for Patient Related Violence and/or Aggression Events During Acute Hospitalisation: A Documentary Analysis.Journal of clinical nursing · 2026Observational
- Article
- Mental Health Nurses' Perceived Appropriateness of Coercive Measures and Security Technologies in Psychiatric Settings: A National Cross-Sectional Study.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Article
- The face of the other in the clinic: reframing patient impoliteness through phenomenological ethics in provider-patient communication.BMC medical ethics · 2026Article
- Incidence of Using Physical, Mechanical Restraints and Seclusion in Saudi Mental Health Settings: A Prospective Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Psychiatrists Under Pressure: Exploring Occupational Risks and Protective Strategies.Iranian journal of psychiatry · 2026Article
- Fairness analysis of machine learning predictions of aggression in acute psychiatric care.Npj mental health research · 2026Article
- Sexual Violence Against Mental Health Nurses in Inpatient Psychiatric Settings: A Systematic Review of Prevalence, Outcomes, and Risk Factors.Nursing reports (Pavia, Italy) · 2026Review
39 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOn psychiatric wards, aggressive behaviour displayed by patients is common and problematic. Understanding factors associated with the development of aggression offers possibilities for prevention and targeted interventions. This review discusses factors that contribute to the development of aggression on psychiatric wards.
methodIn Pubmed and Embase, a search was performed aimed at: prevalence data, ward characteristics, patient and staff factors that are associated with aggressive behaviour and from this search 146 studies were included.
resultsThe prevalence of aggressive behaviour on psychiatric wards varied (8-76%). Explanatory factors of aggressive behaviour were subdivided into patient, staff and ward factors. Patient risk factors were diagnosis of psychotic disorder or bipolar disorder, substance abuse, a history of aggression, younger age. Staff risk factors included male gender, unqualified or temporary staff, job strain, dissatisfaction with the job or management, burn-out and quality of the interaction between patients and staff. Staff protective factors were a good functioning team, good leadership and being involved in treatment decisions. Significant ward risk factors were a higher bed occupancy, busy places on the ward, walking rounds, an unsafe environment, a restrictive environment, lack of structure in the day, smoking and lack of privacy.
conclusionDespite a lack of prospective quantitative data, results did show that aggression arises from a combination of patient factors, staff factors and ward factors. Patient factors were studied most often, however, besides treatment, offering the least possibilities in prevention of aggression development. Future studies should focus more on the earlier stages of aggression such as agitation and on factors that are better suited for preventing aggression such as ward and staff factors. Management and clinicians could adapt staffing and ward in line with these results.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.