Non-pharmacological interventions for reducing aggression and violence in serious mental illness: A systematic review and narrative synthesis

摘要: Abstract Background For people with mental illness that are violent, a range of interventions have been adopted the aim reducing violence outcomes. Many these borrowed from other (offender) populations and their evidence base in Serious Mental Illness (SMI) population is uncertain. Aims To aggregate for non-pharmacological amongst adults SMI PD (Personality Disorder), to assess efficacy interventions. We chose focus on distinct rather than holistic service models where any element responsible therapeutic change would be difficult isolate. Methods performed systematic review narrative synthesis intended reduce patients primary diagnosis PD. Five online databases were searched alongside manual search seven relevant journals, expert opinion was sourced. Eligibility all returned articles independently assessed by two authors, quality studies appraised via Cochrane Collaboration Tool Assessing Risk Bias. Results included 23 studies diverse psychological practical interventions, experimental quasi-experimental study designs 7 Randomised Controlled Trials (RCTs). The majority Mentally Disordered Offenders. stronger existed receiving Cognitive Behavioural Therapy or modified Reasoning & Rehabilitation (R&R). PD, version R&R appeared tolerable Enhanced Thinking Skills showed some promise improving attitudes over short-term, but Dialectical Behaviour this compromised high risk bias. Little could found non-pharmacological, non-psychological Conclusions not conclusive. Long-term outcomes lacking good RCTs required develop base.