Correlates of Involuntary Admission: Findings From an Italian Inpatient Psychiatric Unit

Balducci, Pierfrancesco Maria; Bernardini, Francesco; Pauselli, Luca; Tortorella, Alfonso; Compton, Michael T.

doi:10.24869/psyd.2017.490

Cited by 25 publications

(27 citation statements)

References 38 publications

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“…In line with some studies [47,48,56,62] but in contradiction with other [54], we found that a history of suicidal attempt within the previous 12 months was a negative predictor of involuntary treatment. A possible explanation could be that after non-fatal suicidal attempt the individual may receive more social support from family and friends that, in turn, may increase his/her compliance with treatment and hospitalization [47].…”

Section: Association Between Involuntary Hospitalization(s) and Sociosupporting

confidence: 82%

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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Section: Association Between Involuntary Hospitalization(s) and Sociosupporting

confidence: 82%

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Silva

Antunes

Azeredo‐Lopes

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…The predictors of the present analysis are largely consistent with previous findings: “A history of involuntary admissions proved to be the only independent predictor of involuntary re-admission” in the prospective follow-up study reported by Setkowsky et al (23) and van der Post et al (40). Likewise, functional psychoses (12, 13, 16, 19, 29) and more severe symptoms (15, 16) have been repeatedly reported to increase the risk of compulsory hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

“…- Many analyses focused on specific patient groups, as e.g., (first admitted) subjects with psychosis (25, 26), narrow age categories (25, 27) (adolescents; <50 years old), specific service settings, as e.g., compulsory community treatment (28) or selected countries or areas (14, 26, 29).…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Compulsory Re-admission to Psychiatric Inpatient Care

2019

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Objective: This prospective study addresses risk factors of compulsory re-admission focusing on the role of the patient's subjective symptom distress and perceived social support, based on comprehensive patient and external (clinicians, study staff) assessments. Methods: Of the baseline sample, 168 (71%) patients with serious mental disorders, who had been compulsorily admitted to psychiatric inpatient care, were followed over 24 months after discharge within the framework of a RCT. Results: During this time 36% had compulsory re-admissions; risk was highest immediately after discharge. Regression models identified a history of previous compulsory hospitalisations and compulsory admission due to endangerment of others as the predictors most strongly associated with the outcome. Patients diagnosed with a psychotic disorder or an emotionally instable or combined personality disorder were most likely to experience compulsory re-hospitalisation, with poor response to treatment further significantly increasing the risk. The patient ratings of subjective symptom distress or perceived social support had no predictive value for compulsory re-admission, and this study did not provide evidence for a significant prognostic relevance of sociodemographic background factors. Conclusions: The present findings suggest that within individual-level variables disease-related factors are essentially the strongest predictors, but including the patients' subjective perspective does not enhance the prediction of compulsory re-hospitalisation. The psychiatric treatment of patients with recurrent and often challenging behavioural problems, at the more severe end of the spectrum of mental disorders, deserves closer attention if the use of compulsory hospitalisation is to be reduced.

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“…Furthermore, a weak medication adherence contributed substantially to the decision to mandate an IA in about a third of cases. Discontinuation of medication has been described as a main reason to refer for IA in different countries (41, 43, 50), and a Norwegian study found treatment with neuroleptics to be the most frequently named expectation of general practitioners who referred for IA (40). Nevertheless, a meta-analysis showed that measures to enhance adherence did not significantly reduce the number of IA (56).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Psychiatric Emergency Situations and the Decision-Making Process Leading to Involuntary Admission

et al. 2019

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Introduction: Involuntary admissions to psychiatric hospitals, regardless of their beneficial effects, violate the patients' autonomy. To keep such measures at a minimum and develop less restricting and coercive alternatives, a better understanding of the psychiatric emergency situations which end up in involuntary admissions is needed. This descriptive and exploratory study investigates the consultations leading to involuntary admission and the decision-making process of the referring physicians.Methods: We developed an online questionnaire to collect data on the characteristics of the consultation leading to an involuntary admission, including influencing factors from the referring physicians‘ perspective, as well as their professional background. We included 107 physicians who completed the questionnaire after they had referred patients for involuntary admission to one major psychiatric hospital in Switzerland.Results: The referring physicians were heterogeneous regarding their medical background and experience with psychiatric emergency situations. The consultations were time consuming and took place in various locations. Clinical findings, third-party anamnesis and a known psychiatric diagnosis contributed strongest to the decision to admit involuntarily. “Protection from danger to self” was named most frequently as purpose of the admission.Discussion: This study emphasizes the variety of psychiatric emergency situations leading to involuntary admissions. In most cases, several parties are involved and influence the decision together with medical and social factors. To reduce the number of involuntary admissions, alternatives for patients with a high symptom load and at risk of harming themselves are needed. Possible approaches to achieve that reduction and recommendations for further research are provided.

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Correlates of Involuntary Admission: Findings From an Italian Inpatient Psychiatric Unit

Cited by 25 publications

References 38 publications

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Predictors of Compulsory Re-admission to Psychiatric Inpatient Care

Characteristics of Psychiatric Emergency Situations and the Decision-Making Process Leading to Involuntary Admission

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