Clinical and demographic differences between voluntary and involuntary psychiatric admissions in a university hospital in Brazil

Chang, Tais Michele Minatogawa; Ferreira, Luiz Kobuti; Ferreira, Montezuma Pimenta; Hirata, Edson

doi:10.1590/0102-311x00041313

Cited by 35 publications

(28 citation statements)

References 17 publications

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“…Our results show that during the period of research, 236 patients or 10% were hospitalized by force, while 90%of them were voluntarily admitted to remain at the institution for the purpose of treatment. Similar results were listed over the last decade by other researchers [18]. For all patients, involuntarily detained for treatment in a period of 72 hours, a judge has brought a ruling, in the presence of a commission comprised of physicians not involved patient's treatment, that continuation of involuntary treatment was necessary and determined the length of treatment.…”

Section: Discusionsupporting

confidence: 76%

Necessity and frequency of involuntary hospitalization in psychiatric institution

Nenadović¹

2014

Praxis Med

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Involuntary hospitalization for treatment of mental patients is a necessity in modern scientific psychiatric practice. Hospitalization is generally an act of psychological and social disruption of individual's homeostasis, which is a very important and complex problem for the mentally ill. The goal of the study was to confirm the necessity of involuntary treatment of mental patients in a medical institution, in the interest of patients and the society. The research was conducted as a cross sectional study of hospitalized patients in 2012 at the Clinic for psychiatric disorders "Dr Laza Lazarevic" in Belgrade. It included 2286 inpatients, especially involuntarily hospitalized 236 and 719 admitted for hospital treatment with the assistance of the police. The data were statistically analysed by methods of descriptive statistics: χ2 -test and multiple logistic regression analysis, using the software package SPSS v. 20. The results show that 255 patients were admitted to the hospital for the first time with the assistance of the police. Patients hospitalized with the assistance of the police in compared to those hospitalized without the assistance of the police were, with statistical significance: younger, more frequently males, most frequently in the diagnostic group of schizophrenia and less frequently in the group of organic and affective disorders, most often it was their first, and involuntary hospitalization. During the studied period, 236 (10%) of the total number treated patients were involuntarily hospitalized. There were 176 (74.58%) patients detained for treatment by force, with the assistance of police. There is a necessity for involuntary hospitalization of mental patients. The justification of detaining patients in the health institution by such measures is accomplished through legislation in the best interest of the patient.

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Section: Discusionsupporting

confidence: 76%

Necessity and frequency of involuntary hospitalization in psychiatric institution

Nenadović¹

2014

Praxis Med

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“…Overall, the present study confirmed previous data which show that those with schizophrenia and relevant psychotic disorders are more often involuntary hospitalized 27−38 . Furthermore, additional emphasis needs to be given on educational programmes in pharmacotherapy and treatment options in order to enhance adherence to therapy, since the main cause of relapse herein as well as internationally seems to be non-adherence to pharmacotherapy 27 − 31,39−40 . As for other risk factors for involuntary admission and subsequent compulsory treatment, male gender has been well documented in international literature 3,[28][29][32][33][34][35][36][37][38][41][42][43][44][45][46][47][48][50][51] . Yet, other studies present data which report increased frequency of compulsory treatment among females 9,30,[52][53]55 .…”

Section: Discussionmentioning

confidence: 95%

“…On this basis, it could be considered that, compared to the past or other countries, the diagnosis of severe mental disorder in Cyprus is taking place at an early stage, and subsequently effective treatment is applied, thus restraining possible cognitive implications of severe mental disorders 47 − 48 . The relationship between education level and involuntary admission and/or readmission for compulsory treatment reported herein is also confirmed by other studies 27 . Previous data show an increased incidence of admissions in high security units for compulsory treatment in those with postgraduate education, and in particular holders of diplomas in vocational specializations 3,29,30,43,45,52,56 . This may suggest that in some countries the majority of mental health service users are integrated into professional specialization programmes, which enables them to acquire vocational skills and further prevent occupational exclusion, social isolation and selfstigmatisation 58 .…”

Section: Discussionmentioning

confidence: 98%

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Socio-demographic and clinical characteristics of adults under involuntary hospitalization in the acute mental health services of Cyprus

Kaikoushi¹,

Bella²,

Middleton³

et al. 2019

Preprint

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Background: The clinical and demographic characteristics of the adults involuntary admitted for compulsory mental health treatment have not been reported adequately. Purpose: Investigation of the socio-demographic and clinical characteristics of the adults who are involuntary hospitalized in the acute Mental Health Services in Cyprus. Method: A descriptive correlation study with cross-sectional comparisons was applied. Data collection was performed from December 2016 to February 2018 via a structured questionnaire including demographic and clinical variables. Each questionnaire was accompanied by a consent form, which was assigned by the participants before their discharge. Results: The sample consisted of 406 people, of whom 262 were male and 144 were female. The vast majority were Greek-Cypriots. The largest age groups were 45-65 years (33%) and 25-34 years (31.8%), respectively. 172 of the participants reported current substance use and 117 of them fulfilled the criteria of dual diagnosis. The most frequent diagnosis was schizophrenia or a relevant psychotic disorder (86.4%). The main cause of relapse and subsequent admission was medication non-adherence along with lack of insight (57.1%). 52% of the sample had been previously involuntary hospitalized in a psychiatric hospital. Conclusions: A high percentage of involuntary hospitalizations was noted due to non-adherence to pharmacotherapy. Re-evaluation of the effectiveness of relevant community interventions is suggested, as well as implementation of structured educational programs on therapy adherence during hospitalization. The goal is the limitation of the frequency of relapse while being in the community. Also, education on substance use prevention is also suggested for clinical populations.

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“…Evidence for the impact of other sociodemographic and socioeconomic characteristics on the patient-level has been even less consistent. Altogether, there is some indication that being unemployed or homeless, receiving disability pension or social benefits, being a member of a lower social class and having a lower level of education and poor social support may be associated with higher risks for involuntary hospitalization [9,12,[19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Identification of risk factors for involuntary psychiatric hospitalization: Using environmental socioeconomic data and methods of machine learning to improve prediction

Karasch

Schmitz-Buhl

Mennicken

et al. 2020

Preprint

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Background: The purpose of this study was to identify factors associated with a high risk of involuntary psychiatric in-patient hospitalization both on the individual level and on the level of mental health services and the socioeconomic environment that patients live in. Methods: The present study expands on a previous analysis of the health records of 5764 cases admitted as in-patients in the four psychiatric hospitals of the Metropolitan City of Cologne, Germany, in the year 2011 (1773 cases treated under the Mental Health Act and 3991 cases treated voluntarily). Our previous analysis had included medical, sociodemographic and socioeconomic data of every case and used a machine learning-based prediction model employing chi-squared automatic interaction detection (CHAID). Our current analysis attempts to improve the previous one through (1) optimizing the machine learning procedures (use of a different type of decision-tree prediction model (CART) and application of hyperparameter tuning), and (2) the addition of socioeconomic data on the patients’ environment to the data set. Results: Compared to our previous analysis, model fit was improved. Main diagnoses of an organic mental or a psychotic disorder (ICD-10 groups F0 and F2), suicidal behavior upon admission, admission outside of regular service hours and absence of outpatient treatment prior to admission were confirmed as powerful predictors of detention. Particularly high risks were shown for (1) patients with an organic mental disorder, specifically if they were retired, admitted outside of regular service hours and lived in assisted housing, (2) patients with suicidal tendencies upon admission who did not suffer from an affective disorder, specifically if it was unclear whether there had been previous suicide attempts, or if the affected person lived in areas with high unemployment rates, and (3) patients with psychosis, specifically those who lived in densely built areas with a large proportion of small or one-person households. Conclusions: Certain psychiatric diagnoses and suicidal tendencies are major risk factors for involuntary psychiatric hospitalization. In addition, service-related and environmental socioeconomic factors contribute to the risk for detention. Identifying modifiable risk factors and particularly vulnerable risk groups should help to develop suitable preventive measures.

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Clinical and demographic differences between voluntary and involuntary psychiatric admissions in a university hospital in Brazil

Cited by 35 publications

References 17 publications

Necessity and frequency of involuntary hospitalization in psychiatric institution

Necessity and frequency of involuntary hospitalization in psychiatric institution

Socio-demographic and clinical characteristics of adults under involuntary hospitalization in the acute mental health services of Cyprus

Identification of risk factors for involuntary psychiatric hospitalization: Using environmental socioeconomic data and methods of machine learning to improve prediction

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