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

Hotzy, Florian; Hengartner, Michael Pascal; Hoff, Paul; Jaeger, Matthias; Theodoridou, Anastasia

doi:10.1016/j.eurpsy.2019.04.004

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
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
DOI:	10.1016/j.eurpsy.2019.04.004
Published in:	European Psychiatry
Volume(Issue):	59
Page(s):	70
Pages to:	76
Issue Date:	2019
Publisher / Ed. Institution:	Elsevier
ISSN:	0924-9338 1778-3585
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.
URI:	https://digitalcollection.zhaw.ch/handle/11475/17157
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	Applied Psychology
Organisational Unit:	Psychological Institute (PI)
Appears in collections:	Publikationen Angewandte Psychologie

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Hotzy, F., Hengartner, M. P., Hoff, P., Jaeger, M., & Theodoridou, A. (2019). 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. European Psychiatry, 59, 70–76. https://doi.org/10.1016/j.eurpsy.2019.04.004

Hotzy, F. et al. (2019) ‘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’, European Psychiatry, 59, pp. 70–76. Available at: https://doi.org/10.1016/j.eurpsy.2019.04.004.

F. Hotzy, M. P. Hengartner, P. Hoff, M. Jaeger, and A. Theodoridou, “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,” European Psychiatry, vol. 59, pp. 70–76, 2019, doi: 10.1016/j.eurpsy.2019.04.004.

HOTZY, Florian, Michael Pascal HENGARTNER, Paul HOFF, Matthias JAEGER und Anastasia THEODORIDOU, 2019. 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. European Psychiatry. 2019. Bd. 59, S. 70–76. DOI 10.1016/j.eurpsy.2019.04.004

Hotzy, Florian, Michael Pascal Hengartner, Paul Hoff, Matthias Jaeger, and Anastasia Theodoridou. 2019. “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.” European Psychiatry 59: 70–76. https://doi.org/10.1016/j.eurpsy.2019.04.004.

Hotzy, Florian, et al. “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.” European Psychiatry, vol. 59, 2019, pp. 70–76, https://doi.org/10.1016/j.eurpsy.2019.04.004.