Mental illness may explain some acting outs, but it does not necessarily lead to a dangerous attitude.

Describe the socio-demographic, clinical and therapeutic characteristics of patients considered dangerous and to identify the determinants of psychiatric dangerousness.

We carried out a descriptive and analytical cross-sectional study during six months including patients hospitalized in the psychiatric department at the University Hospital of Mahdia. The data was collected using a 47-item pre-established questionnaire. The assessment of general psychopathology was carried out using the Brief Psychiatric Rating Scale (BPRS) and that of dangerousness using the Historical Clinical Risk-20 scale (HCR-20).

We have collected 143 patients. The average age was 35 years. The majority of patients were single (70.6%). More than half of the population had addictive behaviors (60.1%). Personal psychiatric and criminal histories were present in 81.1% and 11.9% of cases respectively. More than three-quarters of patients (81.8%) were hospitalized without their consent. Hetero-aggressiveness was the main reason for hospitalization (67.8%). The diagnosis was schizophrenia and bipolar disorder type 2 in 21% of cases for each. The evaluation of psychiatric dangerousness by the HCR-20 scale revealed a mean score of 20.6 with an HCR-20 > 20 in 58.7% of cases indicating a high risk of violence. Factors contributing to violent or criminal behavior in psychiatric inpatients were marital status, presence of personal psychiatric history, presence of criminal history and hospitalization modalities.

The results of our study were generally consistent with the data in the literature.

Dangerousness is a state in which a person is likely to commit violent acts.

Describe the socio-demographic and clinical characteristics of psychiatric inpatients hospitalized in the locked unit and suffering from schizophrenia or other psychotic disorders and to assess their dangerousness.

This is a cross-sectional study carried out in the locked unit of psychiatric department of the University Hospital of Mahdia during one year. We have collected data of patients diagnosed with schizophrenia or other psychotic disorders according to DSM 5. Psychometric assessment was done using the BPRS, the PANSS, the VRAG and the HCR-20 scales.

We have included 173 patients. The average age was 36 years with a sex ratio of 9. The majority of our patients were unmarried and of a low economic level. Alcohol and cannabis consumption was found in 7.6% and in 5.7% of cases respectively. A history of incarceration was found in 79% of cases. Homicide was the infraction the most committed in 8% of cases. 71.2% of patients had an anterior hospitalization in the locked unit. Aggressiveness and instability were the main indication for hospitalization. The diagnosis was schizophrenia in 84% of cases. Patients were treated with classic antipsychotic drugs in 55.8% of cases. Non-adherence to treatment was reported in 33% of cases. The average score of psychometric scales were BPRS = 21.4; VRAG = - 4.87 and HCR-20 = 17± 0.87.

Our study showed comparable assessments for dangerousness with the literature. Evaluating dangerousness should represent the first step of the therapeutic process.

Compulsory admission is commonly regarded as necessary and justified for patients whose psychiatric condition represents a severe danger to themselves and others. However, while studies on compulsory admissions have reported on various clinical and social outcomes, little research has focused specifically on dangerousness, which in many countries is the core reason for compulsory admission.

To study changes in dangerousness over time in adult psychiatric patients admitted by compulsory court order, and to relate these changes to these patients' demographic and clinical characteristics.

In this explorative prospective observational cohort study of adult psychiatric patients admitted by compulsory court order, demographic and clinical data were collected at baseline. At baseline and at 6 and 12 month follow-up, dangerousness was assessed using the Dangerousness Inventory, an instrument based on the eight types of dangerousness towards self or others specified in Dutch legislation on compulsory admissions. We used descriptive statistics and logistic regression to analyse the data.

We included 174 participants with a court-ordered compulsory admission. At baseline, the most common dangerousness criterion was inability to cope in society. Any type of severe or very severe dangerousness decreased from 86.2% at baseline to 36.2% at 6 months and to 28.7% at 12 months. Being homeless at baseline was the only variable which was significantly associated with persistently high levels of dangerousness.

Dangerousness decreased in about two-thirds of the patients after court-ordered compulsory admission. It persisted, however, in a substantial minority (approximately one-third).

None.