A 5-year review of physical and verbal aggression in a psychiatric ward in Ilorin, Nigeria

  • A.B. Makanjuola
Keywords: Violence, aggression, psychiatry unit


Objective: Violence on psychiatric wards is increasing globally. Its consequences are not just on the ward staff, but also other patients, relations and hospital facilities. There is a need for more studies especially in developing countries, where not many of such studies have been documented. The study aimed at determining the prevalence of aggression and its clinical and psychosocial factors in a tertiary psychiatric facility in Nigeria.

Method: A review of medical records of all patients admitted to the psychiatric ward, over a 5-year period in the study location.

Result: The prevalence of aggression was found to be 3.6% with Staff Observation Aggression Scale-Revised (SOAS-R) score of 18.1±2.3. Aggression was significantly associated with the male gender (÷2=11.5; p=0.001), first 10 days of admission (÷2=8.0; p=0.005), first 20 minutes of verbal aggression (÷2 = 11.5; p=0.001), and during the evening shift as compared with morning and night duties (÷2=25.3; df=2; p=0.000). At bed occupancy of ≥50%, the chance of physical aggression increased to 84% (÷2=20.5; p=0.000). There was no significant relationship between aggression and patient's religion (÷2=0.5; p=0.8), who patient's delusion is directed at (÷2=0.32; p=0.6) and previous episode of mental illness in patient (÷=00; p=1.0).

Conclusion: The obtained prevalence of 3.6% may be a reflection of under-reporting of aggression. It was suggested that the thrust of management of aggression should be preventive with attention paid to staff training and continuous improvement of ward culture, staff-to-staff and staff-to-patient dynamics and environment.

Keywords: Violence; aggression; psychiatry unit

Original Article

Journal Identifiers

eISSN: 2467-8252
print ISSN: 2360-7793