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August 12, 1968

The Self-Referred Violent Patient

Author Affiliations

From Harvard Medical School and Massachusetts General Hospital, Boston. Drs. Lion and Bach-y-Rita are research fellows in Psychiatry at Harvard Medical School and Massachusetts General Hospital.

JAMA. 1968;205(7):503-505. doi:10.1001/jama.1968.03140330045008

An increasing number of patients now enter hospitals voluntarily with chief complaints of episodic violence, impulsiveness, and destructive urges. Proper evaluation of these patients is often difficult, particularly when the patient is extremely agitated. This communication furnishes guidelines for handling violent patients when they enter a hospital facility. The physician's job has not ended when the patient's acute anxiety has been abated and/or hospitalization has been arranged. If possible, the etiology of the patient's violence should also be established. Are the patient's problems caused by neurological difficulties, psychiatric difficulties, or both? This communication shows how a careful history can help the physician determine whether neurological and/or psychiatric consultations are advisable.