Using de-escalation techniques  for people with psychosis induced aggression or agitation appears to be accepted as good clinical practice but is not supported by evidence from r and omised trials .
BACKGROUND Aggression is a disposition , a willingness to inflict harm , regardless of whether this is behaviourally or verbally expressed and regardless of whether physical harm is sustained .
De-escalation is a psychosocial intervention for managing people with disturbed or aggressive behaviour .
Secondary management strategies such as rapid tranquillisation , physical intervention and seclusion should only be considered once de-escalation and other strategies have failed to calm the service user .
OBJECTIVES To investigate the effects of de-escalation techniques in the short-term management of aggression or agitation  thought or likely to be due to psychosis .
It is unclear why it has remained such an under- research ed area .
Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia.
BACKGROUND A recent review suggested an association between using unpublished scales in clinical trials and finding significant results . AIMS To determine whether such an association existed in schizophrenia trials . METHOD Three hundred trials were r and omly selected from the Cochrane Schizophrenia Group 's Register . All comparisons between treatment groups and control groups using rating scales  were identified . The publication status of each scale was determined and cl aims of a significant treatment effect were recorded . RESULTS Trials were more likely to report that a treatment was superior to control when an unpublished scale was used to make the comparison ( relative risk 1.37 ( 95 % CI 1.12 - 1.68 ) ) . This effect increased when a ' gold-st and ard ' definition of treatment superiority was applied ( RR 1.94 ( 95 % CI 1.35 - 2.79 ) ) . In non-pharmacological trials , one-third of ' gold-st and ard ' cl aims of treatment superiority would not have been made if published scales had been used . CONCLUSIONS Unpublished scales are a source of bias in schizophrenia trials
Using de-escalation techniques  for people with psychosis induced aggression or agitation appears to be accepted as good clinical practice but is not supported by evidence from r and omised trials .
BACKGROUND Aggression is a disposition , a willingness to inflict harm , regardless of whether this is behaviourally or verbally expressed and regardless of whether physical harm is sustained .
De-escalation is a psychosocial intervention for managing people with disturbed or aggressive behaviour .
Secondary management strategies such as rapid tranquillisation , physical intervention and seclusion should only be considered once de-escalation and other strategies have failed to calm the service user .
OBJECTIVES To investigate the effects of de-escalation techniques in the short-term management of aggression or agitation  thought or likely to be due to psychosis .
It is unclear why it has remained such an under- research ed area .