PROSPERO International prospective register of systematic reviews
Non-pharmacological interventions for reducing aggression and violence during
serious mental illness: a systematic review and meta-analysis
Jeremy Rampling, Swaran Singh, Cath Winsper, Steven Marwaha, Max Birchwood
Citation
Jeremy Rampling, Swaran Singh, Cath Winsper, Steven Marwaha, Max Birchwood. Non-pharmacological
interventions for reducing aggression and violence during serious mental illness: a systematic review and metaanalysis. PROSPERO 2014:CRD42014009400 Available from
http://www.crd.york.ac.uk/PROSPERO_REBRANDING/display_record.asp?ID=CRD42014009400
Review question(s)
What is the evidence for non-pharmacological interventions in reducing the recurrence of acts of violence in people
with serious mental illness, specifically schizophrenia, schizoaffective disorder and bipolar disorder. We would also
include patients with a diagnosis of personality disorder due to the overlap between this and psychotic disorders,
although we would intend to analyse these results separately due to phenomenological differences between within
these groups.
Is there evidence for efficacy in the short, medium or long term?
Searches
1) web-based databse search
MEDLINE, EMBASE, PsycINFO, ASSIA, HeinOnline
English language only
Publication since 1980 to date of search
2) Search of reference lists of primary studies identified from initial search
3) Hand search from 2004 to May 2014
- Journal of forensic psychiatry and psychology
- Journal of forensic practice
- Aggression and Violent Behaviour
- British Journal of Psychiatry
- JAMA Psychiatry
4) Liaison with named expert, to be confirmed, for ongoing and recently completed trials
Types of study to be included
No restrictions.
Should the search uncover a large amount of RCTs, these will be reviewed in a sub-section as best evidence.
Condition or domain being studied
Violence (physical, verbal, violent attitudes), within the seriously mentally ill population. Including hostile attitudes,
Page: 1 / 4
outright aggression, offending and recidivism
Participants/ population
Population- serious mental illness including schizophrenia, schizoaffective disorder, bipolar disorder, personality
disorder.
Prisoners/ inpatients and outpatients.
No age restrictions.
Exclude Learning disabilities.
Exclude sexual/domestic violence as interventions for sexual violence have a different focus.
Intervention(s), exposure(s)
Any type of non-pharmacological intervention.
Exclude acute management (restraint/ seclusion).
Comparator(s)/ control
Treatment as usual (ie a group of subjects who did not receive the intervention in question).
Context
Psychiatric inpatients/outpatients and those in prisons with serious mental illness.
Outcome(s)
Primary outcomes
Rates of violence (violent acts/recidivism rates) post intervention.
We will be looking at all aspects to timing to consider if the evidence base is more convincing in the short, medium or
long term.
Secondary outcomes
Attitudes towards violence post intervention.
Data extraction, (selection and coding)
Titles and abstracts will be identified using the search strategy. Two independent researchers will scan all titles and
abstracts to identify relevant articles for full text retrieval. Quality and eligibility of articles will be ascertained by the
same two researchers, who will independently retrieve and analyse the texts.
The same two researchers will manually search the following journals for relevant articles published bwteen 2004 and
date of search:
- Journal of forensic psychiatry and psychology
- Journal of forensic practice
- Aggression and Violent Behaviour
- British Journal of Psychiatry
- JAMA Psychiatry
An expert in the field will be invited to comment on ongoing and recently completed trials.
Any discrepancies or disagreements will be resolved through discussion with a third author.
Page: 2 / 4
Risk of bias (quality) assessment
Once appropriate titles/ abstracts have been selected by two researches independently scanning the search results, the
same two researchers will independently appraise the quality of the papers. Disagreements will be resolved through
discussion or involvement of a third author where necessary.
The authors will use the framework provided by the Cochrane Collaboration to prevent bias, and will rate the final
included studies on their six measures of bias. This information will be used to direct and refine the evidence
synthesis both narratively and quantitatively.
Strategy for data synthesis
This will be directed by the nature of the evidence uncovered by the search. We expect a heterogeneic set of results
and as such expect a narrative synthesis of the findings. Should quantitative analysis be possible with our results, then
we would aim to complete a meta-analysis of the results
Analysis of subgroups or subsets
We would intend to analyse results separately according to type of intervention. Additionally we intend to analyse
results from subjects with a primary diagnosis of personality disorder separately from those with a diagnosis of SMI.
Dissemination plans
The paper will be submitted to a leading journal in the field
Contact details for further information
Jeremy Rampling
Reaside clinic
Birmingham great park
Bristol road south
Birmingham b45 9be
[email protected]
Organisational affiliation of the review
None
Review team
Dr Jeremy Rampling, Birmingham & Solihull Mental Health Foundation Trust
Professor Swaran Singh, University of Warwick
Dr Cath Winsper, University of Warwick
Dr Steven Marwaha, University of Warwick
Professor Max Birchwood, University of Warwick
Details of any existing review of the same topic by the same authors
None known
Anticipated or actual start date
12 May 2014
Anticipated completion date
03 October 2014
Funding sources/sponsors
None
Page: 3 / 4
Conflicts of interest
None known
Language
English
Country
England
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Aggression; Humans; Mental Disorders; Mental Health; Violence
Stage of review
Ongoing
Date of registration in PROSPERO
02 May 2014
Date of publication of this revision
02 May 2014
DOI
10.15124/CRD42014009400
Stage of review at time of this submission
Preliminary searches
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Data extraction
Risk of bias (quality) assessment
Data analysis
Started
Completed
No
No
No
No
No
No
No
No
No
No
No
No
PROSPERO
International prospective register of systematic reviews
The information in this record has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record,
any associated files or external websites.
Page: 4 / 4
Powered by TCPDF (www.tcpdf.org)