Title: Clinical and socio-demographic characteristics associated with involuntary admissions in Switzerland between 2008 and 2016 : an observational cohort study before and after implementation of the new legislation
Authors : Hotzy, Florian
Hengartner, Michael Pascal
Hoff, Paul
Jaeger, Matthias
Theodoridou, Anastasia
Published in : European psychiatry
Volume(Issue) : 59
Pages : 70
Pages to: 76
Publisher / Ed. Institution : Elsevier
Issue Date: 2019
License (according to publishing contract) : Licence according to publishing contract
Type of review: Peer review (Publication)
Language : English
Subjects : Coercion; Involuntary admission; Involuntary hospitalization; Risk-factor; Severe mental illness
Subject (DDC) : 616.89: Mental disorders, clinical psychology and psychiatry
Abstract: Background: Involuntary admission (IA) for psychiatric treatment has a history of controversial discussions. We aimed to describe characteristics of a cohort of involuntarily compared to voluntarily admitted patients regarding clinical and socio-demographic characteristics before and after implementation of the new legislation. Methods: In this observational cohort study, routine data of 15’125 patients who were admitted to the University Hospital of Psychiatry Zurich between 2008 and 2016 were analyzed using a series of generalized estimating equations. Results: At least one IA occurred in 4’560 patients (30.1%). Of the 31’508 admissions 8’843 (28.1%) were involuntary. In the final multivariable model, being a tourist (OR = 3.5) or an asylum seeker (OR = 2.3), having a schizophrenic disorder (OR = 2.1), or a bipolar disorder (OR = 1.8) contributed most to our model. Male gender, higher age, prescription of neuroleptics (all OR < 2.0) as well as having a depressive disorder, prescription of psychotherapy, prescription of antidepressants and admission after implementation of the new legislation (all OR > 0.6) were also weakly associated with IA. Conclusions: Besides schizophrenic or bipolar disorders, a small group of patients had an increased risk for IA due to non-clinical parameters (i.e. tourists and asylum seekers). Knowledge about risk factors should be used for the development of multi-level strategies to prevent frequent (involuntary) hospitalizations in patients at risk. On the organizational level, we could show that the new legislation decreased the risk for IA, and therefore may have succeeded in strengthening patient autonomy.
Departement: Applied Psychology
Organisational Unit: Psychological Institute (PI)
Publication type: Article in scientific Journal
DOI : 10.1016/j.eurpsy.2019.04.004
ISSN: 0924-9338
URI: https://digitalcollection.zhaw.ch/handle/11475/17157
Appears in Collections:Publikationen Angewandte Psychologie

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