NCJ Number
54945
Journal
Journal of the American Medical Association Volume: 205 Issue: 7 Dated: (AUGUST 1968) Pages: 91-93
Date Published
1968
Length
3 pages
Annotation
THESE GUIDELINES FOR PHYSICIANS HANDLING SELF-REPORTED VIOLENT PATIENTS STRESS THE IMPORTANCE OF GATHERING SUFFICIENT ETIOLOGICAL DATA BEFORE DETERMINING WHETHER NEUROLOGICAL OR PSYCHIATRIC SERVICE IS APPROPRIATE.
Abstract
PATIENTS ENTERING A MEDICAL FACILITY WITH COMPLAINTS OF VIOLENT ACTS OR IMPULSIVENESS DIFFER WIDELY IN DEGREES OF ANXIETY. PHYSICIANS SHOULD ASSURE THEM THAT THEY WILL BE PREVENTED FROM COMMITTING VIOLENT ACTS, ADMINISTER CALMING MEDICATION, CALL SECURITY GUARDS IF NECESSARY, AND HOSPITALIZE THE MORE SERIOUS PATIENTS FOR OBSERVATION. EVEN IN THE EVENT THAT HOSPITALIZATION IS NOT NECESSARY, PHYSICIANS SHOULD OBTAIN A CAREFUL MEDICAL AND PSYCHOLOGICAL HISTORY TO ASSIST IN DIAGNOSING AND TREATING THE PATIENT. VIOLENCE MAY BE A SYMPTOM OF NEUROLOGICAL DISORDER IF THE PATIENT COMPLAINS OF HEADACHES OR ALTERING STATES OF CONSCIOUSNESS, HAS EVIDENCED SUBTLE PERSONALITY CHANGES OR A MARKED SEXUAL FUNCTION OR MEMORY ALTERATION, REPORTS A PAST HISTORY OF INFECTION SUCH AS MENINGITIS OR HEAD TRAUMA, HAS A FAMILY HISTORY OF EPILEPSY, OR EXPERIENCES REPEATED RAGE REACTIONS. IF THESE FACTORS ARE NOT CONFIRMED, THEN PHYSICIANS CAN ATTEMPT TO ASSESS THE PATIENT'S PSYCHOLOGICAL HISTORY AND OBTAIN INFORMATION ON FAMILY RELATIONSHIPS, DRUG AND ALCOHOL USE, PERSONALITY ASPECTS SUCH AS IMPULSIVENESS OR DEPRESSION. MOST PATIENTS WILL FALL INTO THE BORDERLINE OR 'SCHIZOID' TYPES, AND WILL REQUIRE SUPPORTIVE THERAPY. REFERENCES ARE PROVIDED. (DAG)