Bipolar Disorder by Kostas N. Fountoulakis

Author:Kostas N. Fountoulakis
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

12.3.5.2 Violence Towards the Caregiver

BD is a mental disorder which is related more than other disorders with bursts of violence especially during acute manic or mixed episodes (Raveendranathan et al. 2012). Especially when combined with overall verbal and physical aggression and behavioural disinhibition, it constitutes a major source of distress for caregivers and the family as a whole (Currier and Allen 2000; Amore et al. 2008).

The literature on the impact of violence and aggression on caregivers of BD patients is limited, but it is reasonable to assume that the ability of family members to predict the bursts of violence could help in preventing them or at least decrease their impact (Raveendranathan et al. 2012; Dore and Romans 2001). It is positive that most caregivers and family members consider acts of violence to be part of the disease and its symptoms rather than under the direct control and responsibility of the patient (Dore and Romans 2001).

Violence and aggression towards the caregiver is frequent with almost half of them having such an experience. At least one in four had experienced a serious act. Far higher is the percentage of caregivers and family members who were afraid that they will be victims of violent acts during an acute episode. It is important to note that violence seems to be more common towards partners than other caregivers and family members and does not seem to be determined by the gender of the patient (Dore and Romans 2001). It is interesting that violence does not seem to have an effect on the caregiver’s mental health appeared (Dore and Romans 2001). From a reverse point of view, it seems that violence is more frequently targeting the close environment and not strangers. It is reported that family members were the victims of violence in 70 % of these violent episodes while 81 % were somehow provoked (Raveendranathan et al. 2012).

However, predicting violence is rather difficult. Interestingly, family members identified three quarters of the patients as irritable only prior to the episode but not in general (Raveendranathan et al. 2012). Only previous history of violence plus male sex, substance abuse and positive symptoms seem to be strong predictive factors (Amore et al. 2008).

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