Violence in Psychiatric Inpatient Wards: Insights from the Persian Version of the Brøset Violence Checklist

This cross-sectional study evaluated the validity and reliability of the Brøset Violence Checklist (BVC) in predicting violent behaviour among psychiatric ward patients in Iran. Additionally, the study aimed to identify demographic and clinical predictors associated with violent acts. It addressed 147 patients in the psychiatric wards of a university hospital north-west of Iran through a descriptive design. Demographic forms, BVC and the Staff Observation Aggression Scale-Revised were assessed. In this context, the translation and content validity and inter-observer reliability of the BVC were also evaluated. The data was analysed using descriptive statistics, the Chi-squared test, logistic regression, and Receiver Operating Characteristic (ROC) curve analysis. Thirty-six patients committed acts of violence. Pre-violent behaviours including boisterousness, physical and verbal threats and attacking objects differed significantly between violent and non-violent patients (p < 0.05), while confusion showed no significant difference. High BVC scores (OR = 6.705, 95% CI = 3.371–13.339, p < 0.001), a diagnosis of bipolar mood disorder (OR = 6.387, 95% CI = 1.077–37.884, p = 0.041) and schizophrenia (OR=19.633, 95% CI= 2.191–175.859, p = 0.008) were significant predictors of violent behaviour. ROC curve analysis identified a BVC cut-off point of 1.5 with a sensitivity of 0.89 and specificity of 0.84. There was a statistically significant difference in the incidence of violence was found between the two groups categorised by this cut-off (X2 = 63.96, p < 0.001). The BVC can be integrated into routine risk assessments during patient admission and hospitalisation in Iranian psychiatric wards.