Protective Biological Factors Against Violence Among Individuals with Severe Mental Illness and High Violence Risk (SMI-V)

Abstract

Introduction: Violence among psychiatric patients, particularly those with Severe Mental Illness and High Violence Risk (SMI-V), is a critical public health issue. This article presents a literature review that synthesizes evidence from relevant academic articles and research studies focusing on patients with serious mental illness and violence (SMI-V), key biological variables associated with violent behavior among individuals with SMI-V, biological treatment approaches, and nursing or case management interventions.

Content: The pathophysiology of violent behavior stems from neurobiological abnormalities, structural brain dysfunctions, neurotransmitter imbalances, and genetic factors. Biological interventions that mitigate these risks include the use of Long-Acting Injectable antipsychotics to maintain stable drug levels and resolve non-adherence issues. Clozapine is indicated for treatment-resistant patients to reduce impulsivity and violent behavior, while acute aggression is managed through emergency protocols utilizing the Overt Aggression Scale (OAS) alongside the administration of Haloperidol or Diazepam. Furthermore, this review emphasizes the importance of Case Management by a multidisciplinary team and a case manager. This approach involves developing clinical pathways, ensuring continuous patient monitoring, and preparing families to control external triggers.

Conclusion: The integration of biological understanding with structured and comprehensive case management may contribute to the prevention of relapse, reduction of the risk of violent behavior, and sustainable improvement in the quality of life of patients, their families, caregivers, and communities.