Predicting coercion during the course of psychiatric hospitalizations

Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Mario Müller [verfasserIn] Nathalie Brackmann [verfasserIn] Matthias Jäger [verfasserIn] Anastasia Theodoridou [verfasserIn] Stefan Vetter [verfasserIn] Erich Seifritz [verfasserIn] Florian Hotzy [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Coercion forced medication psychiatry restraint seclusion

Übergeordnetes Werk:	In: European Psychiatry - Cambridge University Press, 2020, 66(2023)
Übergeordnetes Werk:	volume:66 ; year:2023

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.1192/j.eurpsy.2023.3

Katalog-ID:	DOAJ088115801

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520			\|a Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment.
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allfields	10.1192/j.eurpsy.2023.3 doi (DE-627)DOAJ088115801 (DE-599)DOAJ2ccfc68d5e3c4fd79035baa21dfc5320 DE-627 ger DE-627 rakwb eng RC435-571 Mario Müller verfasserin aut Predicting coercion during the course of psychiatric hospitalizations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment. Coercion forced medication psychiatry restraint seclusion Psychiatry Nathalie Brackmann verfasserin aut Matthias Jäger verfasserin aut Anastasia Theodoridou verfasserin aut Stefan Vetter verfasserin aut Erich Seifritz verfasserin aut Florian Hotzy verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2023.3 kostenfrei https://doaj.org/article/2ccfc68d5e3c4fd79035baa21dfc5320 kostenfrei https://www.cambridge.org/core/product/identifier/S0924933823000032/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
spelling	10.1192/j.eurpsy.2023.3 doi (DE-627)DOAJ088115801 (DE-599)DOAJ2ccfc68d5e3c4fd79035baa21dfc5320 DE-627 ger DE-627 rakwb eng RC435-571 Mario Müller verfasserin aut Predicting coercion during the course of psychiatric hospitalizations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment. Coercion forced medication psychiatry restraint seclusion Psychiatry Nathalie Brackmann verfasserin aut Matthias Jäger verfasserin aut Anastasia Theodoridou verfasserin aut Stefan Vetter verfasserin aut Erich Seifritz verfasserin aut Florian Hotzy verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2023.3 kostenfrei https://doaj.org/article/2ccfc68d5e3c4fd79035baa21dfc5320 kostenfrei https://www.cambridge.org/core/product/identifier/S0924933823000032/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
allfields_unstemmed	10.1192/j.eurpsy.2023.3 doi (DE-627)DOAJ088115801 (DE-599)DOAJ2ccfc68d5e3c4fd79035baa21dfc5320 DE-627 ger DE-627 rakwb eng RC435-571 Mario Müller verfasserin aut Predicting coercion during the course of psychiatric hospitalizations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment. Coercion forced medication psychiatry restraint seclusion Psychiatry Nathalie Brackmann verfasserin aut Matthias Jäger verfasserin aut Anastasia Theodoridou verfasserin aut Stefan Vetter verfasserin aut Erich Seifritz verfasserin aut Florian Hotzy verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2023.3 kostenfrei https://doaj.org/article/2ccfc68d5e3c4fd79035baa21dfc5320 kostenfrei https://www.cambridge.org/core/product/identifier/S0924933823000032/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
allfieldsGer	10.1192/j.eurpsy.2023.3 doi (DE-627)DOAJ088115801 (DE-599)DOAJ2ccfc68d5e3c4fd79035baa21dfc5320 DE-627 ger DE-627 rakwb eng RC435-571 Mario Müller verfasserin aut Predicting coercion during the course of psychiatric hospitalizations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment. Coercion forced medication psychiatry restraint seclusion Psychiatry Nathalie Brackmann verfasserin aut Matthias Jäger verfasserin aut Anastasia Theodoridou verfasserin aut Stefan Vetter verfasserin aut Erich Seifritz verfasserin aut Florian Hotzy verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2023.3 kostenfrei https://doaj.org/article/2ccfc68d5e3c4fd79035baa21dfc5320 kostenfrei https://www.cambridge.org/core/product/identifier/S0924933823000032/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
allfieldsSound	10.1192/j.eurpsy.2023.3 doi (DE-627)DOAJ088115801 (DE-599)DOAJ2ccfc68d5e3c4fd79035baa21dfc5320 DE-627 ger DE-627 rakwb eng RC435-571 Mario Müller verfasserin aut Predicting coercion during the course of psychiatric hospitalizations 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment. Coercion forced medication psychiatry restraint seclusion Psychiatry Nathalie Brackmann verfasserin aut Matthias Jäger verfasserin aut Anastasia Theodoridou verfasserin aut Stefan Vetter verfasserin aut Erich Seifritz verfasserin aut Florian Hotzy verfasserin aut In European Psychiatry Cambridge University Press, 2020 66(2023) (DE-627)320445070 (DE-600)2005377-0 17783585 nnns volume:66 year:2023 https://doi.org/10.1192/j.eurpsy.2023.3 kostenfrei https://doaj.org/article/2ccfc68d5e3c4fd79035baa21dfc5320 kostenfrei https://www.cambridge.org/core/product/identifier/S0924933823000032/type/journal_article kostenfrei https://doaj.org/toc/0924-9338 Journal toc kostenfrei https://doaj.org/toc/1778-3585 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_217 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_2004 GBV_ILN_2014 GBV_ILN_2110 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 66 2023
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author	Mario Müller
spellingShingle	Mario Müller misc RC435-571 misc Coercion misc forced medication misc psychiatry misc restraint misc seclusion misc Psychiatry Predicting coercion during the course of psychiatric hospitalizations
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topic_title	RC435-571 Predicting coercion during the course of psychiatric hospitalizations Coercion forced medication psychiatry restraint seclusion
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title	Predicting coercion during the course of psychiatric hospitalizations
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title_sort	predicting coercion during the course of psychiatric hospitalizations
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title_auth	Predicting coercion during the course of psychiatric hospitalizations
abstract	Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment.
abstractGer	Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment.
abstract_unstemmed	Abstract Background Coercive measures (such as seclusion, mechanical restraint, and forced medication) during psychiatric inpatient treatment should be avoided whenever possible. Different interventions were already developed to reduce coercion, but for their effective application, it is crucial to know the risk factors of individuals and clinical situations that might be associated with coercion. Since the results of previous studies differ considerably the current study aims to fill this gap by evaluating the course of the exertion of coercion in detail. Methods In this study, we analyzed clinical, procedural, and sociodemographic data from patients (n = 16,607 cases) who were treated as inpatients in Switzerland’s largest psychiatric institution with 320 beds during the years 2017 to 2020. We used regression models to identify predictors for the exertion of coercion, the number of coercive measures during a treatment episode and time until exertion of the first and last coercive measure. Results Coercive measures are mostly used during the first days of treatment. We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. In particular, interventions should focus on the critical timeframe at the beginning of treatment.
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title_short	Predicting coercion during the course of psychiatric hospitalizations
url	https://doi.org/10.1192/j.eurpsy.2023.3 https://doaj.org/article/2ccfc68d5e3c4fd79035baa21dfc5320 https://www.cambridge.org/core/product/identifier/S0924933823000032/type/journal_article https://doaj.org/toc/0924-9338 https://doaj.org/toc/1778-3585
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author2	Nathalie Brackmann Matthias Jäger Anastasia Theodoridou Stefan Vetter Erich Seifritz Florian Hotzy
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up_date	2024-07-03T15:54:04.162Z
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We identified clinical parameters such as manic or psychotic episodes to be the most relevant predictors for the exertion of coercion. Cases with those disorders also received coercion more often and earlier in their treatment course than other diagnostic groups. Other promoting factors for frequency and early application of coercion were involuntary admission and factors of chronicity and clinical severity. Conclusions Knowing the risk factors may help to target preventive strategies for those at highest risk. 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Predicting coercion during the course of psychiatric hospitalizations

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