II. Risk Factors

  1. Schizophrenia or other Psychosis (e.g. paranoid Delusions)
  2. Personality Disorder
  3. Prior Violent Behavior
  4. Access to weapons
  5. Substance Abuse or Alcohol Abuse
  6. Prior victimization (e.g. Bullying victim)

III. Symptoms: Behavior Preceding Violent Outbursts

  1. Confusion
  2. Irritability
  3. Boisterous
  4. Physical or verbal threats
  5. Attacks on objects

IV. Management: Emergency Department

V. Management: Disposition of patient with Suicidality or homicidality

  1. Involuntary committment indications
    1. Mental illness
    2. Danger to self or others due to mental illness
    3. Not intoxicated
    4. Restrictive disposition for safety
  2. No formal guidelines on how access to weapons (e.g. firearms) directs the disposition
    1. Some states mandate reporting if firearm access in a patient at risk for Violence
    2. Apply best clinical judgement, and err on the side of safety
    3. Work to remove access to weapons in unclear situations
    4. Notifying police of credible threat to the patient or others does not breach HIPAA

VI. Complications

VII. References

  1. Barsotti in Herbert (2015) EM:Rap 15(4): 12-14

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Ontology: Dangerous Behavior (C0010967)

Definition (MSH) Actions which have a high risk of being harmful or injurious to oneself or others.
Concepts Individual Behavior (T055)
MSH D003617
English Behavior, Dangerous, Dangerous Behavior, Dangerous Behaviors, Behaviors, Hazardous, Hazardous Behaviors, Hazardous Behavior, Behavior, Hazardous
Swedish Riskbeteende
Czech nebezpečné chování, hazardní chování
Finnish Vaarallinen käyttäytyminen
Russian UGROZHAIUSHCHEE POVEDENIE, POVEDENIE UGROZHAIUSHCHEE, ПОВЕДЕНИЕ УГРОЖАЮЩЕЕ, УГРОЖАЮЩЕЕ ПОВЕДЕНИЕ
Japanese 危険行動, 危険な行動, 行動-危険
Croatian OPASNO PONAŠANJE
Polish Zachowanie niebezpieczne
Norwegian Risikofylt atferd, Hasardiøs atferd, Farlig atferd
French Comportement dangereux
German Gefährliches Verhalten, Verhalten, gefährliches
Italian Comportamento pericoloso
Dutch Gedrag, gevaarlijk, Gevaarlijk gedrag
Portuguese Comportamento Perigoso, Conduta Imprudente
Spanish Conducta Imprudente, Conducta Peligrosa

Ontology: Dangerousness (C0010968)

Concepts Idea or Concept (T078)
MSH D003617
German Gefährlichkeit
French Dangerosité
Norwegian Farlighet
English Dangerousness

Ontology: Physical aggression (C0424323)

Concepts Finding (T033)
ICD10 R45.6
SnomedCT 248004009
Dutch gewelddadig gedrag
French Comportement violent
German gewalttaetiges Verhalten
Italian Comportamento violento
Portuguese Comportamento violento
Spanish Comportamiento violento, agresión física (hallazgo), agresión física, conducta violenta
Japanese 暴力行為, ボウリョクコウイ
English Physical assaultive behavior, Physical assaultive behaviour, violent behavior, demonstrated violent behavior, demonstrated violent behavior (physical finding), violent behavior (symptom), demonstrated behavior violent, the demonstrated behavior was violent, behaviors violent, behavior violent, violent behaviour, Violent Behavior, Violent Behaviour, Physical aggression, Violent behavior, Violent behaviour, Physically assaultive behavior, Physically assaultive behaviour, Physical aggression (finding)
Czech Násilné chování
Hungarian Erőszakos viselkedés, Erőszakos magatartás

Ontology: Homicidal thoughts (C0455204)

Concepts Finding (T033)
ICD9 V62.85
ICD10 R45.850
SnomedCT 225450009
Italian Ideazione omicida
Japanese 殺人念慮, サツジンネンリョ
English homicidal thought content (physical finding), homicidal thought content, homicidal ideation, homicidal ideation (physical finding), homicidal thoughts, intellectual content homicidal, homicidal thoughts (symptom), Homicidal ideations, Homicidal ideation, Homicidal thoughts, Homicidal thoughts (finding)
Czech Vražedné myšlenky
Hungarian Gyilkossági gondolatok
Spanish ideas homicidas, pensamientos de homicidio (hallazgo), pensamientos de homicidio, Ideación homicida
Portuguese Ideação homicida
Dutch moordgedachte
French Idées d'homicide
German Mordgedanken

Ontology: Dangerous and harmful thoughts (C0563168)

Concepts Mental Process (T041)
SnomedCT 285261008
English Dangerous and harmful thoughts, Evil rumination, Dangerous and harmful thoughts (finding)
Spanish pensamientos peligrosos y dañinos (hallazgo), pensamientos peligrosos y dañinos