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Social Psychiatry and Psychiatric Epidemiology

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01.02.2007 | ORIGINAL PAPER

Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics

verfasst von: Prof. Dr. Med. Tilman Steinert, Veronika Martin, Manfred Baur, Ulrich Bohnet, Rita Goebel, Gottfried Hermelink, Rita Kronstorfer, Wolfgang Kuster, Beate Martinez-Funk, Martin Roser, Albrecht Schwink, Wolfram Voigtländer

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 2/2007

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Abstract

Objective

To investigate the incidence of coercive measures in standard psychiatric care in different psychiatric hospitals.

Methods

We developed a common documentation of mechanical restraint, seclusion, and medication by coercion, and introduced it in 10 participating hospitals. We developed software able to process the data and to calculate four key indicators for routine clinical use.

Results

9.5% of 36,690 cases treated in 2004 were exposed to coercive measures with the highest percentage among patients with organic psychiatric disorders (ICD-10 F0) (28.0%). Coercive measures were applied a mean 5.4 times per case and lasted a mean 9.7 h each. The incidence and duration of coercive measures varied highly between different diagnostic groups and different hospitals. Use of detailed guidelines for seclusion and restraint was associated with a lower incidence of coercive measures.

Discussion

Data interpretation should consider numerous confounding factors such as case mix and hospital characteristics. Suggestions on how to cope with ethical and technical problems in the processing of large multi-site data sets in routine clinical use are made.

Jones K (1984) Robert Gardiner Hill and the non-restraint movement. Can J Psychiatry 29:121–124PubMed

Colaizzi J (2005) Seclusion and restraint: a historical perspective. J Psychosoc Nurs Mental Health Serv 43:31–37

Sailas E, Fenton M (2000) Seclusion and restraint for people with serious mental illnesses. The Cochrane database of systematic reviews, p CD 001163

Fisher WA (1994) Restraint and seclusion: a review of the literature. Am J Psychiatry 151:1585–1591

Needham I, Abderhalden C, et al. (2002) Coercive procedures and facilities in Swiss Psychiatry. Swiss Medical Weekly 132:253–258PubMed

Salib E, Ahmed AG, Cope M (1998) Practice of seclusion: a five-year retrospective review in North Cheshire. Med Sci Law 38:321–327PubMed

Savage L, Salib E (1999) Seclusion in psychiatry. Nurs Stand 13:34–37PubMed

Nijman HLI, Palmstierna T, Almvik R, Stolker JJ (2005) Fifteen years of research with the Staff Observation Aggression Scale—a review. Acta Psychiatr Scand 111:12–21PubMedCrossRef

Frueh BC, Knapp RG, Cusack KJ, Grubaugh AL, Sauvageot JA, Cousins VC, Yim E, Robins CS, Monnier J, Hiers TG (2005) Patients’ reports of traumatic or harmful experiences within the psychiatric setting. Psychiatr Serv 56:1123–1133PubMedCrossRef

10.

Meyer H, Taiminen T, Vuori T, Aijälä A, Helenius H (1999) Post-traumatic stress disorder symptoms related to psychosis and acute involuntary hospitalisation in schizophrenic and delusional patients. J Nerv Ment Dis 187:343–352PubMedCrossRef

11.

Priebe S, Bröker M, Gunkel S (1998) Involuntary admission and posttraumatic stress disorder symptoms in schizophrenia patients. Compr Psychiatry 39:220–224PubMedCrossRef

12.

Betemps EJ, Buncher CR, Oden M (1992) Length of time spent in seclusion and restraint by patients at 82 VA medical centers. Hosp Com Psychiatry 43:912–914

13.

Betemps EJ, Somoza E, et al. (1993) Hospital characteristics, diagnoses and staff reasons associated with use of seclusion and restraint. Hosp Com Psychiatry 44:367–371

14.

Crenshaw WB, Francis PS (1995) A national survey on seclusion and restraint in state psychiatric hospitals. Psychiatr Serv 46:1026–1031PubMed

15.

Crenshaw WB, Cane KA (1997) An updated national survey on seclusion and restraint. Psychiatr Serv 48:395–397PubMed

16.

Gerlock A, Solomons HC (1983) Factors associated with the seclusion of psychiatric patients. Perspect Psychiatr Care 21:46–53PubMedCrossRef

17.

Glover RW (2005) Reducing the use of seclusion and restraint: a NASDMHPD priority. Psychiatr Serv 56:1141–1142PubMedCrossRef

18.

Smith GM, Davis RH, Bixler EO, Lin HM, Altenor A, Altenor RJ, Hardentstine BD, Kopchick GA (2005) Pennsylvania State Hospital System’s seclusion and restraint reduction program. Psychiatr Serv 56:1115–1122PubMedCrossRef

19.

Kaltiala-Heino R, Korkeila J, Tuohimäki C, et al. (2000) Coercion and restrictions in psychiatric inpatient treatment. Eur Psychiatry 15:213–219PubMedCrossRef

20.

Ketelsen R, Zechert C, et al. (2001) Entwicklung eines Kooperationsmodells zwischen drei psychiatrischen Kliniken mit dem Ziel der Qualitätssicherung bei Zwangsmaßnahmen am Beispiel der Fixierungsdokumentation. Psychiat Prax 28:69–74CrossRef

21.

Steinert T (2000) Reduzierung von Gewalt und Zwang an psychiatrischen Kliniken. Krankenhauspsychiatrie 11:53–59

22.

Howell DC (2000) Resampling procedures. URL: http://www.uvm.edu/∼dhowell/StatPages/Resampling/Resampling.html

23.

Fritz U, Mack B, Rave-Schwank M (1991) Gewalt in der Psychiatrie. Evaluation der Fixierungsdokumentation in einem psychiatrischen Krankenhaus. Psychiat Prax 18:162–166

24.

Klimitz H, Uhlemann H, Fähndrich E (1998) Fixieren wir zu häufig? Indikation, Häufigkeit und Randbedingungen von Fixierungen in einer allgemeinpsychiatrischen Abteilung. Psychiat Prax 25:235–239

25.

Swett C (1994) Inpatient seclusion: description and causes. Bull Am Acad Psychiatry Law 22:421–430PubMed

26.

Tunde-Ayinmode M, Little H (2004) Use of seclusion in an psychiatric acute inpatient unit. Austr Psychiatry 12:347–353CrossRef

27.

Thompson P (1986) The use of seclusion in psychiatric hospitals in the Newcastle area. Br J Psychiatry 149:471–474PubMedCrossRef

28.

Tardiff K (1981) Emergency control measures for psychiatric inpatients. J Nerv Ment Dis 169:614–618PubMedCrossRef

29.

Brown JS, Tooke SK (1992) On the seclusion of psychiatric patients. Soc Sci Med 35:711–721PubMedCrossRef

30.

Bush AB, Shore MF (2000) Seclusion and restraint; a review of recent literature. Harv Rev Psychiatry 8:261–270CrossRef

31.

Esther RJ (1997) Use of physical restraints in a nineteenth-century state hospital. Hist Psychiatry 8:83–93PubMedCrossRef

Titel: Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics
verfasst von: Prof. Dr. Med. Tilman Steinert
Veronika Martin
Manfred Baur
Ulrich Bohnet
Rita Goebel
Gottfried Hermelink
Rita Kronstorfer
Wolfgang Kuster
Beate Martinez-Funk
Martin Roser
Albrecht Schwink
Wolfram Voigtländer
Publikationsdatum: 01.02.2007
Verlag: D. Steinkopff-Verlag
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 2/2007
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-006-0137-0

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Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics