BMC Psychiatry最新文献

{"title":"Validation of the Thai version of the modified social functioning scale (SFS) for individuals with schizophrenia.","authors":"Warut Aunjitsakul, Kanthee Anantapong, Aimorn Jiraphan, Teerapat Teetharatkul, Katti Sathaporn, Napakkawat Buathong, Pakawat Wiwattanaworaset","doi":"10.1186/s12888-025-07049-y","DOIUrl":"10.1186/s12888-025-07049-y","url":null,"abstract":"<p><strong>Background: </strong>The Social Functioning Scale (SFS) is widely used to evaluate social functioning in individuals with schizophrenia. While validated in various cultural contexts, adaptation for Thailand is necessary to address cultural and contextual nuances. This study aimed to translate and culturally adapt the SFS into Thai and assess its reliability and validity.</p><p><strong>Methods: </strong>A sample of 109 individuals (52.3% female) diagnosed with schizophrenia was recruited from a university hospital in Thailand. Exploratory Factor Analysis (EFA) and reliability tests were conducted on six subscales of the Modified SFS- Thai version. Concurrent validity was assessed using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), Social and Occupational Functioning Assessment Scale (SOFAS), Scale for the Assessment of Positive Symptoms (SAPS), and Scale for the Assessment of Negative Symptoms (SANS).</p><p><strong>Results: </strong>EFA of four subscales-Independence Performance, Recreation, Pro-Social, and Independence Competence-revealed distinct factor structures with strong loadings. The Employment and Withdrawal/Interpersonal subscales could not undergo EFA due to binary items and insufficient sampling adequacy. Cronbach's alpha values of the modified subscales ranged from 0.75 to 0.87, indicating good internal consistency. Significant correlations with WHODAS 2.0, SOFAS, SAPS, and SANS confirmed the scale's validity.</p><p><strong>Conclusions: </strong>The Modified SFS- Thai version is a reliable and valid tool for assessing social functioning in individuals with schizophrenia. Its cultural adaptation enhances its relevance in Southeast Asia, offering valuable insights for clinical practice and research in low- and middle-income countries.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"589"},"PeriodicalIF":3.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying factors related to sertraline concentrations in child/adolescent and adult patients: insights from a therapeutic drug monitoring service.","authors":"Ruoming Li, Bin Bi, Zhe Dong, Sai Chen, Yuan Yun, Xiuhuan Wang, Hasenqimuge, Song Chen, Yunlong Tan","doi":"10.1186/s12888-025-07033-6","DOIUrl":"10.1186/s12888-025-07033-6","url":null,"abstract":"<p><strong>Introduction: </strong>Sertraline, a widely prescribed antidepressant, has considerable variability in serum concentrations. This retrospective study aimed to identify key determinants influencing sertraline concentrations, with a special focus on age-related differences.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of TDM data from 1076 patients (474 children/adolescents and 602 adults) collected between 2018 and 2024. Multivariable generalized linear regression and restricted cubic spline models were used to examine the relationships between clinical parameters and sertraline concentrations.</p><p><strong>Results: </strong>The daily dose and aspartate aminotransferase (AST) level were positively correlated with the sertraline concentration in both age groups. Sex had a significant effect, with women exhibiting 43% (P = 0.001) and 37% (P = 0.001) higher concentrations than men in the child/adolescent and adult groups, respectively. In children and adolescents, the albumin (Alb) level and neutrophil (NEUT) count also considerably influence concentrations. CYP2C19 poor metabolizers (PMs) tended to be present at relatively high concentrations, but the difference was not statistically significant. Among child and adolescent patients, significant differences in dose-adjusted serum concentration (C/D) values (P = 0.0291) were observed across different CYP2C19 phenotypes, with PMs exhibiting higher C/D values. In a cohort of 593 patients who underwent high-sensitivity C-reactive protein (hsCRP) testing, a nonlinear, U-shaped correlation between hsCRP levels and sertraline concentrations was identified in children and adolescents.</p><p><strong>Discussion: </strong>By identifying key factors such as daily dose, sex and AST levels, clinicians can develop tailored treatment plans for individual patients. These findings underscore the need for further research to elucidate the interplay between sertraline metabolism and patients' physiological and pathological characteristics.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"590"},"PeriodicalIF":3.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological mechanisms of revenge and revenge ideations in family homicide: results from qualitative research of forensic assessment reports.","authors":"L H Grobbink, K M L Huijbregts, S Draisma, J J L Derksen, G J Westerhof","doi":"10.1186/s12888-025-07021-w","DOIUrl":"10.1186/s12888-025-07021-w","url":null,"abstract":"<p><p>Our aim was to find out which social and psychological factors characterize forensic psychiatric patients who have committed family homicide with revenge as a reason as compared to subjects who committed family homicide with other motives. Qualitative research was carried out on the basis of pre-trial forensic assessment reports of existing cases (N=20), divided between Revenge and No-Revenge cases. In case of revenge, violence was almost always a sort of settling of an interpersonal score. Psychotic symptomatology was absent in the Revenge cases, personality problems (particularly borderline and narcissistic traits) were common. Demoralization because of a decline of well-being seems to be an important factor pushing some persons with such vulnerabilities over the edge. Our expectation is that, at least in a certain proportion of (non-psychotic) patients, there will be more brooding on revenge than the psychotherapist suspects.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"582"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic predictors of mental health service utilization among young adults with support in daily living in Sweden: a register-based study.","authors":"Jenny Meyer, Sergej Engström, Maria Löthberg, Steve Berggren, Adriana Ramirez, Sonya Girdler, Tatja Hirvikoski, Sven Bölte, Ulf Jonsson","doi":"10.1186/s12888-025-07046-1","DOIUrl":"10.1186/s12888-025-07046-1","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of young adults in Sweden are being granted support in daily living through social services. To enhance service planning and resource allocation for this growing group of young service users, we aimed to provide an overview of the social and health-related circumstances of young adults recently granted support in daily living. We had a particular focus on mental health service utilization and whether socio-demographic factors influence the use of care.</p><p><strong>Methods: </strong>Swedish nationwide register data were used to describe the sociodemographic characteristics and utilization of mental health services, including outpatient and inpatient care, treatment for suicidal behavior and pharmacological treatment. Sociodemographic predictors (sex, age, country of birth, education, and parental education) of mental health service utilization were explored using binary logistic regression.</p><p><strong>Results: </strong>All young adults (ages 18-29) granted support between 2017 and 2021 (N = 15,024; 49.2% female) were included. Unfavorable social circumstances were common, including truncated education, unemployment, and the need for financial assistance. Many had a history of psychiatric inpatient care (40.0%) and treatment for suicidal behavior (15.7%). The majority received psychiatric outpatient care (71.6%) and psychopharmacological treatment (73.9%) during their granting year. Common conditions for care included attention deficit hyperactivity disorder, anxiety and fear-related disorders, mood disorders, and autism spectrum disorder. Co-occurring conditions were prevalent. Utilization of mental health services was more common among females, particularly regarding treatment for suicidal behavior (adjusted OR 2.52; 95% CI 2.16-2.93). Higher educational level and being Swedish-born were associated with a greater likelihood of utilizing outpatient care and psychopharmacological treatment. In contrast, those born in Sweden were less likely than foreign-born to be admitted to inpatient care (adjusted OR 0.66; 95% CI 0.59-0.74).</p><p><strong>Conclusions: </strong>While social services recognize the support needs of this group of young adults, our findings suggest that sociodemographic characteristics such as sex, education level, and country of birth may facilitate or obstruct their access to mental health services. It is essential to coordinate efforts so that young adults with support in daily living can seek and access the mental health services they need.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"580"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Extended-release amphetamine (Dyanavel XR) is associated with reduced immediate-release supplementation in adults with ADHD, regardless of baseline patient variables: a retrospective cohort analysis of medical treatment records.","authors":"Joel L Young, Richard N Powell, Anna Powell, Lisa L M Welling, Lauren Granata, Jaime Saal, Margot Nash","doi":"10.1186/s12888-025-06903-3","DOIUrl":"10.1186/s12888-025-06903-3","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"583"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-injurious behavior in Greek adolescents: the role of mental health problems and COVID-19 trauma.","authors":"Georgios Giannakopoulos, Foivos Zaravinos-Tsakos, Efrosyni Pilafa, Andre Sourander, Gerasimos Kolaitis","doi":"10.1186/s12888-025-07040-7","DOIUrl":"10.1186/s12888-025-07040-7","url":null,"abstract":"<p><strong>Background: </strong>Self-injurious behavior (SIB) in adolescents is a pressing public health issue, compounded by emotional dysregulation, behavioral challenges, and increased suicide risk. While much research has focused on interpersonal trauma, the impact of non-interpersonal traumatic events-such as those stemming from the COVID-19 pandemic-remains less clear.</p><p><strong>Methods: </strong>We investigated the associations between SIB, mental health difficulties, and COVID-19-related traumatic stress in a non-clinical sample of 5,612 Greek adolescents (55.4% female; mean age = 13.42 ± 0.96 years) from the Global Child and Adolescent Mental Health Study. Participants completed the Strengths and Difficulties Questionnaire (SDQ) to assess emotional symptoms, conduct problems, hyperactivity, and peer difficulties, and the Children's Revised Impact of Event Scale-8 (CRIES-8) to evaluate post-traumatic stress symptoms. SIB was assessed via self-report, and specific COVID-19-related experiences (e.g., quarantine, hospitalization) were recorded alongside measures of suicidal ideation and suicide attempts.</p><p><strong>Results: </strong>Overall, 25.5% (n = 1,424) of adolescents reported engaging in SIB, 28.1% (n = 1,566) endorsed suicidal ideation, and 8.4% (n = 471) had attempted suicide. Adolescents reporting SIB had significantly higher total SDQ scores (M = 17.47 [SD = 5.82]) than those without (M = 11.22 [SD = 5.40]; p < 0.001). In logistic regression analyses, each one-point increase in emotional symptoms (OR = 1.17, 95% CI [1.12, 1.21]), conduct problems (OR = 1.17, 95% CI [1.12, 1.23]), and peer problems (OR = 1.08, 95% CI [1.03, 1.15]), as well as each one-point decrease in prosocial behavior (OR = 0.92, 95% CI [0.88, 0.96]), significantly elevated the odds of SIB. Moreover, higher intrusive symptoms on the CRIES-8 were modestly associated with increased odds of SIB (OR = 1.03, 95% CI [1.01, 1.05]). Among COVID-19-related experiences, personal hospitalization due to COVID-19 predicted SIB (OR = 1.26, 95% CI [1.04, 1.53]). Additionally, female gender (OR = 2.33, 95% CI [2.04, 2.63]), suicidal ideation (OR = 4.82, 95% CI [4.09, 5.69]), and a history of suicide attempts (OR = 5.08, 95% CI [3.77, 6.83]) further compounded the risk.</p><p><strong>Conclusions: </strong>Our findings demonstrate a multifaceted interplay between mental health difficulties and trauma-related stress in the emergence of SIB among adolescents. These data highlight the importance of early detection and targeted interventions addressing both emotional dysregulation and trauma-specific symptoms, particularly for youth with direct, severe COVID-19 experiences, to mitigate SIB and its associated risks.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"579"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a sensory modulation intervention in mental health outpatient services: a process evaluation study.","authors":"Klara Forsberg, Daniel Sutton, Sigrid Stjernswärd, Ulrika Bejerholm, Elisabeth Argentzell","doi":"10.1186/s12888-025-07034-5","DOIUrl":"10.1186/s12888-025-07034-5","url":null,"abstract":"<p><strong>Background: </strong>Mental health service users often experience difficulties interpreting and regulating sensory stimuli resulting in increased anxiety, decreased abilities to engage in activities and a hampered recovery process. However, there are limited studies on the implementation of such recovery-oriented interventions targeting sensory difficulties via sensory modulation techniques. Therefore, the aim of this study was to investigate staff and manager views on the implementation process of a group-based sensory modulation intervention in mental health outpatient services in Southern Sweden.</p><p><strong>Methods: </strong>This mixed method implementation process evaluation included eight outpatient units, which were also study sites for a Randomized Controlled Trial (RCT) (NCT06432114), evaluating the effectiveness of the sensory modulation intervention. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using deductive and inductive content analysis.</p><p><strong>Results: </strong>The results indicated that the intervention was highly accepted by the mental health staff. The dose delivered and received were high and the intervention in general met the needs of the target group. Managers and staff reflections indicated that following the intervention service users seemed to feel better prepared to handle anxiety in daily life due to the acquisition of new sensory coping strategies. Staff expressed that they benefitted from acquiring a different perspective or \"new sensory glasses\" to apply in their clinical practice. However, managers' and staff reflections also highlighted the need for an adapted manual for people with cognitive issues and more education for staff.</p><p><strong>Conclusions: </strong>This study contributed to new knowledge of implementing a recovery-oriented sensory modulation intervention in mental health outpatient services. The implementation was generally carried out as intended. Nonetheless, certain challenges emerged during the implementation process, both within the contextual environment and during the delivery of the intervention.</p><p><strong>Trial registration: </strong>Retrospectively registered 20,240,529, in ClinicalTrials.gov NCT06432114.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"581"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining youth-centred practice in mental health care.","authors":"Alec Cook, Renee Hunt, Jennifer Silcox, Eugenia Canas, Arlene G MacDougall","doi":"10.1186/s12888-025-06864-7","DOIUrl":"10.1186/s12888-025-06864-7","url":null,"abstract":"<p><strong>Background: </strong>Like many other nations, the rates of mental illness among children and youth have risen. Youth and emerging adults (YEA) between the ages of 16 and 25, in particular, have the highest rate of mental health disorders of any age group leading clinicians and researchers to ponder new and innovative ways to treat mental ill health (1-2). Youth centred practices (YCP) have emerged as possible new approaches in youth mental health care to better treat YEA living with mental illness, but also to empower this population to take control of their wellbeing. Despite the growing use of the term 'youth-centred,' there is little consensus on what this looks like in mental health care for youth. Using research coming out of MINDS of London-Middlesex, we explore how mental health professionals, including clinicians, researchers, administrative staff, and trainees, understand the term YCP and how they implement youth-centredness in practice.</p><p><strong>Methods: </strong>Using a Youth Participatory Action Research framework as a guide, MINDS' researchers worked alongside YEA research assistants in all phases of research. Participants were selected from a pool of known practitioners and mental health programs utilizing YCP, as identified by YEA research assistants. Qualitative focus group and interviews, developed using an appreciative inquiry approach, were conducted with 13 mental health care professionals, staff, and trainees to ascertain how they understand and practice YCP. Researchers conducted a codebook thematic analysis of the data: five themes and fourteen subthemes were identified.</p><p><strong>Results: </strong>Our analysis identified five main themes: (1) Acknowledging YCP's Role in Supporting YEA Mental Health; (2) Developing Authentic and Meaningful Relationships Between YEA and Care Providers; (3) Collaboration in Care: Engaging YEA as Active Agents in their Treatment; (4) Creation and Maintenance of Accessible Service to Facilitate YEA Engagement; and (5) Moving Beyond Tacit Knowledge to YCP as a Trainable Construct. Underlying each of these key components of YCP was a thread of recognition that systems of care for YEA must be responsive to the unique needs of those the system intends to serve. This process is seen as dynamic and fluid; often representative of societal change and growth, the specific needs of YEA will remain in flux and YCP approaches require continued reflexivity.</p><p><strong>Conclusions: </strong>When YCPs are used in mental health care, YEA and their lived experiences are respected by trusted adults on their care team. At the core, YCPs are collaborative. There is a shift from the dynamic of \"practitioner as expert\" to one that provides YEA a sense of agency and autonomy to make informed decisions regarding their care.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"578"},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world pharmacotherapy treatment patterns among patients diagnosed with postpartum depression in the United States.","authors":"D Claire Miller, Devika Chawla, Katherine Johansen Taber, Jennifer L Payne, Andria L Del Tredici","doi":"10.1186/s12888-025-06977-z","DOIUrl":"10.1186/s12888-025-06977-z","url":null,"abstract":"<p><strong>Background: </strong>Pharmacotherapy is one modality recommended to treat postpartum depression (PPD), but treatment patterns are not well characterized. In this study we characterized psychiatric medications used to treat PPD in real-world settings.</p><p><strong>Methods: </strong>Two cohorts of patients diagnosed with PPD within 180 days of delivery between October 2015 and January 2022 were retrospectively studied using two U.S. claims databases (Symphony Health [SH], Myriad Genetics-Komodo Health [MGKH]). Prescription fills of select psychiatric medications in the 365 days after PPD diagnosis were assessed using pharmacy claims.</p><p><strong>Results: </strong>The two cohorts (SH, MGKH) included 124,742 and 22,141 patients with PPD, respectively. Most patients with PPD (SH: 64.9%, MGKH: 76.4%) filled at least 1 prescription in the year following diagnosis; of those, 76.4% and 62.7%, respectively, discontinued treatment at least once. Medication changes were also common among treated patients, with 16.6% in SH and 18.3% in MGKH filling 3 or more unique psychiatric medications. In each cohort, selective serotonin reuptake inhibitors (SSRIs) comprised 72.2% of observed first-line treatments following PPD diagnosis, and sertraline was the most common first-line SSRI (39.4% and 41.4% of first-line treatments, respectively). Later-line therapies were not dominated by any single medication or medication class.</p><p><strong>Conclusions: </strong>While the majority of patients with PPD were prescribed pharmacotherapy, treatment patterns were heterogeneous and characterized by frequent discontinuation and medication switching. These results suggest that first-line treatments may fail, and that some patients may need multiple medication trials to improve symptoms.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"572"},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors for seclusion and restraint: results of a retrospective analysis.","authors":"Alexandre Wullschleger, Marie Chieze, Delphine Courvoisier, Samia Hurst, Othman Sentissi, Stefan Kaiser","doi":"10.1186/s12888-025-07025-6","DOIUrl":"10.1186/s12888-025-07025-6","url":null,"abstract":"<p><strong>Background: </strong>The reduction of coercion is a central challenge of inpatient mental health services. Little is known about the use of seclusion and restraint in open-door settings. This work aims to analyse the prevalence and risk factors of coercive measures in open inpatient wards of a Swiss university psychiatric hospital.</p><p><strong>Methods: </strong>The use of seclusion and restraint was retrospectively analysed between 2017 and 2019. Incidence rate ratios using multivariable Poisson regressions were calculated to determine patient- and hospital stay-related risk factors for coercion.</p><p><strong>Results: </strong>Of 1764 patients, 293 (16.6%) underwent at least one coercive measure (mostly seclusion) during their stay. The experience of coercive measures was associated with the following factors: male gender (IRR 1.34 [1.26, 1.38], p < 0.001), younger age (IRR 0.97 [0.97, 0.97], p < 0.001), being single or divorced (IRR 1.49 [1.43, 1.60], p < 0.001), diagnoses of organic (IRR 13.43 [13.38, 13.48], p < 0.001), psychotic (IRR 1.79 [1.79, 1.79], p < 0.001), or bipolar (IRR 2.17 [2.16, 2.17], p < 0.001) disorders, receiving disability benefits (IRR 1.92 [1.90, 2.07], p < 0.001), higher number of previous psychiatric hospitalizations (IRR 1.03 [1.03, 1.03], p < 0.001), and higher Health of the Nation Outcome Scales (HoNOS) item 1-scores (overactive, aggressive, or agitated behaviour) at admission 1.27 [1.27, 1.27], p < 0.001). Referrals from the emergency department (ED) (IRR 0.78 [0.77, 0.86], p < 0.001) were associated with a lower risk of coercion.</p><p><strong>Conclusions: </strong>Young age, being single or divorced, male gender, diagnoses of organic, bipolar, or psychotic disorders, being on disability benefits, and previous psychiatric hospitalizations were identified as risk factors of coercion. The incidence of coercion was lower in ED referrals. Item 1 HoNOS scores at admission might be sufficient for a meaningful assessment of coercion risk. Our results suggest a strong link between aggressive behaviour and the use of coercive measures. Identification of patients at risk should be integrated to coercion reduction programs. The role of institutional and cultural factors influencing the use of coercion should be further investigated.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"576"},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}