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One-year incidence and prevalence of seclusion: Dutch findings in an international perspective

Social Psychiatry and Psychiatric Epidemiology volume 50, pages 1857–1869 (2015)Cite this article

An Erratum to this article was published on 25 September 2015

Abstract

Background

The Netherlands started a nationwide coercion reduction program in 2007. In 2011, accurate registration of coercive measures became obligatory by law.

Objective

The aim of this study was to compare number and duration of coercive measures in the Netherlands with international data.

Methods

2011 data on coercive measures were collected, using a system developed in Germany. To understand determinants of coercion, multilevel logistic regression was performed.

Results

12.0 % (n = 5169) of patients (n = 42.960) in 2011 experienced at least one coercive measure. Exposure to coercion was comparable to other countries, and duration was higher. Medication use seemed to half average times in seclusion. In the Netherlands, coercion mainly constituted of seclusion and occurred in bipolar and psychotic disorders. In Germany, coercion was mostly mechanical restraint and occurred in organic disorders and schizophrenia.

Conclusions

Gathering comprehensive data allows comparisons between countries, increasing our understanding of the impact of different cultures, legislation and health care systems on coercion. In the Netherlands, seclusion is still the main type of coercion, despite significant improvements in the last few years. It is shorter when applied in combination with enforced medication.

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Acknowledgments

This study was supported by a grant of the Dutch Ministry of Health Welfare and Sports.

Author information

Affiliations

  1. GGnet Community Mental Health Centre, Warnsveld, The Netherlands

    Eric Noorthoorn

  2. Hogeschool Windesheim, Zwolle, The Netherlands

    Wim Janssen

  3. Dutch Case Register Coercive Measures, Altrecht Aventurijn, Den Dolder, The Netherlands

    Eric Noorthoorn & Wim Janssen

  4. Radboud University of Nijmegen, Nijmegen, The Netherlands

    Henk Nijman

  5. Altrecht Aventurijn, Den Dolder, The Netherlands

    Henk Nijman

  6. Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

    Adriaan Hoogendoorn

  7. Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

    Guy Widdershoven

  8. Bangor University, Bangor, Wales, United Kingdom

    Peter Lepping

  9. Centres for Psychiatry Suedwuerttemberg, Ulm University, Ulm, Germany

    Tilman Steinert

  10. Mysore Medical College and Research Institute, Mysore, India

    Peter Lepping

  11. Wrexham Community Mental Health Team, University Health Board, Wrexham Maelor Hospital, Wrexham, Wales

    Peter Lepping

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  1. Eric Noorthoorn
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  2. Peter Lepping
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  3. Wim Janssen
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Correspondence to Eric Noorthoorn.

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All procedures performed in the current study were in accordance with the ethical standards of the National Research committee as obtained in 2006 and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Data were analysed on fully anonymized data of which none of the cases could be identified to an individual.

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Noorthoorn, E., Lepping, P., Janssen, W. et al. One-year incidence and prevalence of seclusion: Dutch findings in an international perspective. Soc Psychiatry Psychiatr Epidemiol 50, 1857–1869 (2015). https://doi.org/10.1007/s00127-015-1094-2

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Keywords

  • Coercion
  • Seclusion
  • Restraint
  • Determinants
  • International comparison