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Screening for Risk Factors Associated with Violence in Pediatric Patients Presenting to a Psychiatric Emergency Department

GIGGIE, MARISA A., MD, MPAff; OLVERA, RENE L., MD, MPH; JOSHI, MEGHNA N., MD

Journal of Psychiatric Practice®: July 2007 - Volume 13 - Issue 4 - p 246-252
doi: 10.1097/01.pra.0000281485.96698.6d
Winner of Resident Paper Award 2006-2007
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Objective. This exploratory study was a chart review that examined whether risk factors for violence were adequately reported in 425 pediatric patients assessed by psychiatry residents in a psychiatric emergency room.

Results. Overall, psychiatric residents rarely documented asking about important risk factors such as gun access, gang affiliation, history of police contact, and domestic violence; however, high rates of positive endorsement were found when queries concerning risk factors were documented in the chart. Despite being the most common method of homicide/suicide in youth, gun access was assessed by residents in only 3% of patients. Domestic violence was endorsed as positive 100% of the time when it was documented. Pediatric patients presenting with violence were more likely to be screened for past violence than those with suicide and other complaints. Males were more likely to have a history of prior violence.

Conclusions. Most psychiatric residents failed to document thorough risk assessments for violence in pediatric patients in an emergency setting. This has important medical-legal and treatment planning implications.

GIGGIE: at submission, University of Texas Health Science Center at San Antonio, TX; currently Staff Psychiatrist, Taylor Hardin Secure Medical Facility, Tuscaloosa, AL; OLVERA: University of Texas Health Science Center at San Antonio, TX; JOSHI: at submission, University of Texas Health Science Center at San Antonio; currently, Texas A&M University-Scott & White., Temple, TX.

Please send correspondence and reprint requests to: Marisa A. Giggie, MD, MPAff, Taylor Hardin Secure Medical Facility, 1301 Jack Warner Blvd NE, Tuscaloosa, AL 35406. m.giggie@sbcglobal.net

Copyright © 2007 Wolters Kluwer Health, Inc. All rights reserved.