Sociodemographic, Circumstantial, and Psychopathological Predictors of Involuntary Admission of Patients with Acute Psychosis

IF 1.2 Q4 PSYCHIATRY
J. Seifert, Christian Ihlefeld, Tristan Zindler, C. Eberlein, M. Deest, S. Bleich, S. Toto, C. Meissner
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引用次数: 2

Abstract

Studies have consistently determined that patients with acute psychosis are more likely to be involuntarily admitted, although few studies examine specific risk factors of involuntary admission (IA) among this patient group. Data from all patients presenting in the psychiatric emergency department (PED) over a period of one year were extracted. Acute psychosis was identified using specific diagnostic criteria. Predictors of IA were determined using logistic regression analysis. Out of 2533 emergency consultations, 597 patients presented with symptoms of acute psychosis, of whom 118 were involuntarily admitted (19.8%). Involuntarily admitted patients were more likely to arrive via police escort (odds ratio (OR) 10.94) or ambulance (OR 2.95), live in a psychiatric residency/nursing home (OR 2.76), report non-adherence to medication (OR 2.39), and were less likely to suffer from (comorbid) substance abuse (OR 0.53). Use of mechanical restraint was significantly associated with IA (OR 13.31). Among psychopathological aspects, aggressiveness was related to the highest risk of IA (OR 6.18), followed by suicidal intent (OR 5.54), disorientation (OR 4.66), tangential thinking (OR 3.95), and suspiciousness (OR 2.80). Patients stating fears were less likely to be involuntarily admitted (OR 0.25). By understanding the surrounding influencing factors, patient care can be improved with the aim of reducing the use of coercion.
急性精神病患者非自愿入院的社会人口学、环境和精神病理学预测因素
研究一致认为,急性精神病患者更有可能是非自愿入院,尽管很少有研究检查非自愿入院(IA)的具体危险因素。从精神科急诊科(PED)一年内所有患者的数据被提取出来。急性精神病是用特定的诊断标准确定的。采用logistic回归分析确定IA的预测因素。在2533例急诊就诊中,597例患者出现急性精神病症状,其中118例是非自愿入院(19.8%)。非自愿入院的患者更有可能通过警察护送(比值比(OR) 10.94)或救护车(OR 2.95)到达,住在精神病院/疗养院(OR 2.76),报告不遵守药物治疗(OR 2.39),并且不太可能患有(共病)药物滥用(OR 0.53)。机械约束的使用与IA显著相关(OR 13.31)。在精神病理方面,攻击性与IA的风险最高(OR 6.18),其次是自杀意图(OR 5.54)、定向障碍(OR 4.66)、切向思维(OR 3.95)和多疑(OR 2.80)。表示恐惧的患者不太可能非自愿入院(OR 0.25)。通过了解周围的影响因素,可以改善病人的护理,以减少强迫的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.90
自引率
0.00%
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审稿时长
11 weeks
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