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.
Lion JR, Bach-y-Rita G, Ervin FR. The Self-Referred Violent Patient. JAMA. 1968;205(7):503–505. doi:10.1001/jama.1968.03140330045008
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