• A J Tholen.
• Universitair Centrum Psychiatrie, Universitair Medisch Centrum Groningen. a.j.tholen@psy.umcg.nl
• Tijdschr Psychiatr. 2009 Jan 1;51(3):173-82.

BackgroundIn general psychiatry the risk of violence has to be assessed regularly, for instance in cases where civil commitment is under consideration.AimThis article gives an overview of the actuarial instruments for risk assessment, discusses a model for the clinical assessment of risks of violence and for the compulsory management of such risks.MethodThe relevant literature was located via cross-references from key publications and via bibliographic references in specialized journals. The key words used in the search were violence, violent behaviour, dangerousness, risk assessment, risk prediction and risk management.ResultsStandardised actuarial assessment of the risk of violence is only of limited value in general psychiatric practice. Among certain high-risk groups standardised instruments targeted at the specific type of risk (acute, long-term) and at the type of decision (relating to security, treatment) can have added value within a broader clinical assessment.ConclusionIn general psychiatric practice a potential risk of violence should be assessed systematically in a structured manner. If there are risks of violence these can best be studied and assessed in specialised clinics or by specialized teams. Dynamic risk factors and protective factors should be evaluated systematically in cooperation with the various organizations concerned.

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