Peer Reviewed
Psychological medicine

Dealing with the violent or aggressive patient

Matthew Large, Olav B Nielssen

In most instances of patient aggression or violence in primary care settings, an understanding of the reason for the aggression will help management. Violence and aggression are closely related and often stem from anger. In psychosis and confusional states, however, the emotion behind aggression is often fear.

Key Points

    Aggression by patients in primary care settings can interfere with medical treatment and is a source of anxiety about personal safety. Aggression can also be an important sign of a mental disorder and present a focus for intervention in a range of underlying conditions. Aggression in a medical setting can be defined as a hostile or threatening attitude, as distinct from violence, which is defined as forceful behaviour intended to damage or harm. The two are closely related, and both frequently stem from the emotion of anger. However, aggression is often not associated with actual violence, and violence is not always a result of anger. In patients with psychosis or confusional states, the emotion behind aggression is often fear.

    Picture credit: © Phanie/Garo/

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