Social Psychiatry and Psychiatric Epidemiology

, Volume 42, Issue 2, pp 140–145 | Cite as

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

  • 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



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


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.


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.


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.


seclusion restraint involuntary medication predictor guideline 



We thank Dr. Peter Lepping, Wrexham Maelor Hospital, Wales, for language corrections. The German Ministry of Health and Social Welfare funded the project.


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Tilman Steinert
    • 1
  • Veronika Martin
    • 1
  • Manfred Baur
    • 2
  • Ulrich Bohnet
    • 3
  • Rita Goebel
    • 1
  • Gottfried Hermelink
    • 4
  • Rita Kronstorfer
    • 5
    • 6
  • Wolfgang Kuster
    • 7
  • Beate Martinez-Funk
    • 8
  • Martin Roser
    • 9
  • Albrecht Schwink
    • 10
  • Wolfram Voigtländer
    • 11
  1. 1.Centre of Psychiatry WeißenauUniversity of UlmRavensburg-WeißenauGermany
  2. 2.Bezirkskrankenhaus KaufbeurenKaufbeurenGermany
  3. 3.Zentrum für Psychiatrie ReichenauReichenauGermany
  4. 4.Vinzenz von Paul HospitalRottweilGermany
  5. 5.Klinikum am WeißenhofWeinsbergGermany
  6. 6.Wrexham Maelor HospitalWrexhamUK
  7. 7.Klinik für Psychiatrie und NeurologieWinnendenGermany
  8. 8.Klinik an der LindenhöheOffenburgGermany
  9. 9.Klinikum NordschwarzwaldCalw-HirsauGermany
  10. 10.Zentrum für Psychiatrie EmmendingeEmmendingenGermany
  11. 11.Klinikum HeidenheimHeidenheimGermany

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