Compulsory admissions of emergency psychiatric inpatients in Turin: The role of diagnosis

Montemagni, Cristiana; Frieri, Tiziana; Villari, Vincenzo; Rocca, Paola

doi:10.1016/j.pnpbp.2012.06.020

Cited by 14 publications

(19 citation statements)

References 43 publications

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“…Les caractéristiques identifiées dans notre étude, notamment la présence d'un trouble mental grave, des comportements liés à la dangerosité, un historique d'hospitalisation involontaire et un isolement social, sont comparables à celles provenant des études consultées (de Stefano et Ducci, 2008 ;Montemagni et al, 2012). Ce profil clinique correspond à une crise de nature psychopathologique qui se distingue par des épisodes récurrents (Aimé, LeBlanc, Séguin, Brunet, Brisebois et Girard, 2014 ;Séguin, Brunet et LeBlanc, 2011).…”

Section: Discussionunclassified

“…Les personnes à risque d'être hospitalisées de façon involontaire ont tendance à présenter un trouble mental de type psychotique (Bindman et Thornicroft, 2008), à cumuler des antécédents d'hospitalisation involontaire (van der Post et al, 2009) et à vivre un isolement social (van der Post et al, 2012). Des études récentes ont montré qu'une fois certaines caractéristiques cliniques considérées, le diagnostic ne permet pas en soi de prédire l'hospitalisation involontaire (Braitman, Guedj, Masson, de Carvalho, Gallois et Lana, 2011 ;Montemagni, Frieri, Villari et Rocca, 2012). Ces caractéristiques cliniques qui influencent la décision médicale d'hospitaliser une personne contre sa volonté se rapportent principalement à la dépendance à une substance (McGarvey, Leon-Verdin, Wanchek et Bonnie, 2013), à l'agitation aux urgences (Braitman et al, 2011) et à un profil agressif suspicieux (Montemagni et al, 2012).…”

Section: Facteurs Contextuels Associés à La Variation Des Taux D'hospunclassified

“…Des études récentes ont montré qu'une fois certaines caractéristiques cliniques considérées, le diagnostic ne permet pas en soi de prédire l'hospitalisation involontaire (Braitman, Guedj, Masson, de Carvalho, Gallois et Lana, 2011 ;Montemagni, Frieri, Villari et Rocca, 2012). Ces caractéristiques cliniques qui influencent la décision médicale d'hospitaliser une personne contre sa volonté se rapportent principalement à la dépendance à une substance (McGarvey, Leon-Verdin, Wanchek et Bonnie, 2013), à l'agitation aux urgences (Braitman et al, 2011) et à un profil agressif suspicieux (Montemagni et al, 2012). Il s'ensuit des défis importants pour les professionnels qui doivent appliquer la loi tout en mettant l'accent sur la démarche pour obtenir le consentement d'une personne en situation de crise et présentant un danger.…”

Section: Facteurs Contextuels Associés à La Variation Des Taux D'hospunclassified

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Évaluation de l’implantation d’un nouveau protocole de garde en établissement : profil de la clientèle, audit de dossiers et recommandations

Leblanc

2014

smq

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Les difficultés d’application des réformes législatives visant à réduire l’hospitalisation involontaire des personnes qui présentent un danger pour elles-mêmes ou pour autrui ont été soulevées dans de nombreux rapports, tant au Québec qu’ailleurs. Pour aplanir ces difficultés, un nouveau protocole de garde en établissement a été élaboré et implanté dans la région de l’Outaouais. La présente étude a pour but d’évaluer son implantation et ce faisant, établir le profil des personnes mises sous garde en établissement. Les résultats indiquent que la majorité de ces personnes sont aux prises avec des troubles mentaux graves et que les professionnels perçoivent positivement le nouveau protocole, sans toutefois faire le nécessaire pour consigner de façon rigoureuse les données dans les formulaires requis. Il est recommandé de non seulement informer les professionnels sur la procédure légale, mais aussi s’assurer que la structure organisationnelle est propice à son implantation.Since the 1990s, legislative reforms have been undertaken in many Western countries to reduce involuntary hospitalization. Studies examining fluctuation rates before and after the legislative reform show a general trend toward an increase rather than a decrease in involuntary hospitalization rates (de Stefano & Ducci, 2008). In Quebec, many reports have shown that consent for psychiatric evaluation and hospitalisation for people who present an imminent danger to themselves or to others is difficult to obtain due to clinical, legal, and ethical considerations. To facilitate this process, a new protocol was developed and implemented following the training of 335 health workers and 85 medical doctors in 6 hospitals. Our study evaluated this protocol and established a profile of people who had been hospitalized against their will. Using a retrospective analysis, we examined the files of 179 patients who underwent a psychiatric evaluation process during an involuntary hospitalization. This file analysis allowed us to develop a better profile of these people and determine whether the required forms were present and how adequately they were filled out by the professionals. We also conducted a study with the professionals responsible for applying the new protocol to get a better idea of its characteristics (relative advantage, compatibility, simplicity, reversibility and observability) as well as the principles of consent and the obstacles to its implementation.Our study showed that that half of the patients were diagnosed with schizophrenia or another psychosis. Fifty-four point two percent (54.2%) of the patients were males, 79% were single or separated and only 18,4% were working. At the time of their crisis situation, 30,7% were brought to the hospital by police officers and 19% were already hospitalized. The remaining patients were brought in by ambulance, family members or they came in by themselves. Professional opinion of the new protocol was positive however they did not rigorously enter the data required in the new forms. The new form was present...

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Section: Discussionunclassified

Section: Facteurs Contextuels Associés à La Variation Des Taux D'hospunclassified

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Évaluation de l’implantation d’un nouveau protocole de garde en établissement : profil de la clientèle, audit de dossiers et recommandations

Leblanc

2014

smq

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“…Since no de nition of diagnosis is provided by legal frameworks, it is important to understand what speci c pathways and mechanisms might increase the risk for involuntary admission in someone with psychosis. One study found that hostility and suspiciousness were signi cant compulsory admission determinants, and that diagnosis had no longer any independent in uence on the risk of involuntary hospitalization after controlling for these speci c symptoms [48]. A high level of suspiciousness and uncooperativeness might go hand in hand with reduced coping-strategies and insight, and lead to poor medication adherence and impaired capacity to establish a therapeutic alliance [51,60,62], explaining the higher risk of involuntary hospitalization in psychosis.…”

Section: Association Between Involuntary Hospitalization(s) and Sociomentioning

confidence: 99%

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Silva

Antunes

Azeredo‐Lopes

et al. 2020

Preprint

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BackgroundIdentifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012.MethodsData from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors.ResultsMale gender [exp(β̂) = 1.31; 95%CI:1.06-1.62, p<0.05], having secondary and higher education [exp(β̂) = 1.45; 95%CI:1.05-2.01, p<0.05, and exp(β̂) = 1.89; 95%CI:1.38-2.60, p<0.001, respectively], a psychiatric diagnosis of psychosis [exp(β̂) = 2.02; 95%CI:1.59-2.59, p<0.001], and being admitted in 2007 and in 2012 [exp(β̂) = 1.61; 95%CI:1.21-2.16, p<0.01, and exp(β̂) = 1.73; 95%CI:1.31-2.32, p<0.001, respectively] were associated with an increment of involuntary hospitalizations. Being married/cohabitating [exp(β̂) = 0.74; 95%CI:0.56-0.99, p<0.05], having experienced a suicide attempt [exp(β̂) = 0.26; 95%CI:0.15-0.42, p<0.001], and belonging to the catchment area of three of the psychiatric units evaluated [exp(n) =0.65; 95%CI:0.49-0.86, p<0.01, exp(β̂) = 0.67; 95%CI:0.49-0.90, p<0.01, and exp(β̂) = 0.67; 95%CI:0.46-0.96, p<0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively] were associated with a decrease in involuntary hospitalizations.ConclusionsThe findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with sociodemographic, clinical, and contextual factors. This information may help to recognize high-risk patients, and to inform the development of better-targeted preventive interventions to reduce these hospitalizations.

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“…The general socio-demographic characteristics of the whole sample have been recently reported (Montemagni et al 2012, Frieri et al 2013.…”

Section: Subject Characteristicsmentioning

confidence: 99%

Associations Between Functional Milestones and Psychiatric Admissions in an Urban Area: Utility of a Cluster-Analytical Approach

Montemagni¹,

Frieri²,

Villari³

2018

Psychiat Danub

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Background:The purpose of the study was to identify homogenous subgroups, based upon achievement of two functional milestones (marriage and employment) and Global Assessment of Functioning (GAF) score in a sample of 848 acute patients admitted to the Psychiatric Emergency Service (PES) of the Città della Salute e della Scienza di Torino, during a 24-months period.Subjects and methods: A two-step cluster-analysis, using GAF total score and the achievements in the two milestones as input data was performed. In order to examine whether the identified subgroups differed in external variables that were not included in the clustering process, and consequently to validate the found functional profiles, chi-square tests for categorical variables and analyses of variance (ANOVA) for continuous variables were performed.Results: Five clusters were found. Employed patients (Clusters 4 and 5) had more years of education, less illness chronicity (shorter duration of illness and lower proportion of previous voluntary hospitalizations), lower use of mental health resources in the last year yet higher treatment adherence, larger network size, and higher ordinary discharge. Married inpatients (Clusters 3 and 5) had lower frequencies of substance abuse.Conclusions: The remarkably high rate of unemployment in this inpatients' sample, and the evidence of associations between unemployment and poorer functioning, argue for further research and development of evidence-based supported employment programs, that put forth diligent effort in helping people obtain work quickly and sustain; they may also help to reduce health care service use among that clientele.

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Compulsory admissions of emergency psychiatric inpatients in Turin: The role of diagnosis

Cited by 14 publications

References 43 publications

Évaluation de l’implantation d’un nouveau protocole de garde en établissement : profil de la clientèle, audit de dossiers et recommandations

Évaluation de l’implantation d’un nouveau protocole de garde en établissement : profil de la clientèle, audit de dossiers et recommandations

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Associations Between Functional Milestones and Psychiatric Admissions in an Urban Area: Utility of a Cluster-Analytical Approach

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