Abstract

Objective The management of patients with mental disorder and violent behavior has become one of the most important issues among psychiatrists, due to repercussions related to professional liability. The aim of this study is to identify an assesment methodology of patients with mental disorder and violent behaviors oriented to manage the risk of violent behavior in clinical practice, particularly focusing on both stimulating and protective factors.
Methods This study is a personal contribution based on clinical experience among specific institutions specialized in the evaluation and treatment of psychiatric patients, who committed violent crimes. The presented methodology is based on contributions of clinical reports and the most recent literature.
Results and conclusions Authors present a methodology of assessment of patients with a mental disorder and violent behaviors including categorical psychiatric diagnosis, dimensional psychiatric diagnosis, dynamic psychiatric diagnosis, etiologic evaluation of violent behavior, the assesment of transference, countertransference and resistance of the patient. The treatment trend that emerges includes a sequence of operative indications that concern the treatment of both mental disorder and violent behavior, beyond the adoption of protective measures. It is also specified that the evaluation of the risk have to focus on the specific patient. We ought to, at least, emphasize the importance to document in case histories, the evaluation of the violent behavior risk carried-out, as a concrete proof of good clinical practice.

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