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

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Abstract

Objective

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

Methods

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.

Results

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.

Discussion

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.

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Acknowledgements

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

Author information

Author notes

  1. Rita Kronstorfer

    Present address: Wrexham Maelor Hospital, Wrexham, Wales, UK

Authors and Affiliations

  1. Centre of Psychiatry Weißenau, University of Ulm, Weingartshofer Straße 2, 88214, Ravensburg-Weißenau, Germany

    Tilman Steinert, Veronika Martin & Rita Goebel

  2. Bezirkskrankenhaus Kaufbeuren, Kaufbeuren, Germany

    Manfred Baur

  3. Zentrum für Psychiatrie Reichenau, Reichenau, Germany

    Ulrich Bohnet

  4. Vinzenz von Paul Hospital, Rottweil, Germany

    Gottfried Hermelink

  5. Klinikum am Weißenhof, Weinsberg, Germany

    Rita Kronstorfer

  6. Klinik für Psychiatrie und Neurologie, Winnenden, Germany

    Wolfgang Kuster

  7. Klinik an der Lindenhöhe, Offenburg, Germany

    Beate Martinez-Funk

  8. Klinikum Nordschwarzwald, Calw-Hirsau, Germany

    Martin Roser

  9. Zentrum für Psychiatrie Emmendinge, Emmendingen, Germany

    Albrecht Schwink

  10. Klinikum Heidenheim, Heidenheim, Germany

    Wolfram Voigtländer

Authors
  1. Tilman Steinert
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  2. Veronika Martin
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  4. Ulrich Bohnet
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  6. Rita Kronstorfer
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  7. Wolfgang Kuster
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  8. Beate Martinez-Funk
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  9. Martin Roser
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  10. Albrecht Schwink
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  11. Wolfram Voigtländer
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Corresponding author

Correspondence to Tilman Steinert.

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Steinert, T., Martin, V., Baur, M. et al. Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics. Soc Psychiat Epidemiol 42, 140–145 (2007). https://doi.org/10.1007/s00127-006-0137-0

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  • DOI: https://doi.org/10.1007/s00127-006-0137-0

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