OBJECTIVE: The authors determined the rates and patterns of violence
toward persons by psychiatric patients before admission to the inpatient
service of the Payne Whitney Clinic and determined which factors were
associated with a greater risk of violence. METHOD: During hospitalization,
763 patients were interviewed by a research assistant using a structured
interview instrument. The interviewer inquired about demographic and
socioeconomic information and about history of violence and alcohol and
drug use. RESULTS: Having physically attacked another person in the month
before admission was equally likely among male (13.6%) and female (14.7%)
patients. The patterns of violence were similar for men and women in terms
of target, severity of injuries, use of a weapon, and place of occurrence.
Univariate analyses showed that only youth was associated with violence for
male patients, while youth, low socioeconomic status, substance abuse, and
axis II pathology were associated with a greater risk of violence for
female patients. Logistic regression analyses showed that recent cocaine
use was significantly associated with violence by female patients when age,
socioeconomic status, and axis II pathology were controlled for. For male
patients, recent heroin use was related to a greater risk of violence.
CONCLUSIONS: The frequency of violence by female patients was 150% higher
than it was in a study at the Payne Whitney Clinic a decade ago. The
frequency of violence by male patients was 50% higher than it was a decade
ago. In the current study, substance abuse was associated with greater risk
of violence by patients.