[Restraint and seclusion in psychiatry: review and prospects].
In this article, the authors reviewed the literature published since 1965 concerning restraint and seclusion. They synthesized the contents of the articles reviewed using the categories of indications and contraindications; rates of seclusion and restraint as well as demographic, clinical, and environmental factors that affect these rates; effects on patients and staff; implementation; and training. The literature on restraint and seclusion supports the following: 1) Seclusion and restraint are basically efficacious in preventing injury and reducing agitation; 2) It is nearly impossible to operate a program for severely symptomatic individuals without some form of seclusion or physical or mechanical restraint; 3) Demographic and clinical factors have limited influence on rates of restraint and seclusion; 4) Training in prediction and prevention of violence, in self-defense, and in implementation of restraint and/or seclusion is valuable in reducing rates and untoward effects; 5) Studies comparing well-defined training programs have potential usefulness.
Palazzolo
J
J
CHU de Grenoble, Hôpital Sud, BP 185, 38042 Grenoble.
Favre
P
P
Vittini
P
P
Bougerol
T
T
D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010356:Patient Isolation / Q000379:methods* / Q000706:statistics & numerical data; D012149:Restraint, Physical / Q000379:methods* / Q000706:statistics & numerical data