title: Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics.
abstract: OBJECTIVE
  To investigate the incidence of coercive measures in standard psychiatric care in different psychiatric hospitals.
  
  
  METHODS
  We developed a common documentation of mechanical restraint, seclusion, and medication by coercion, and introduced it in 10 participating hospitals. We developed software able to process the data and to calculate four key indicators for routine clinical use.
  
  
  RESULTS
  9.5% of 36,690 cases treated in 2004 were exposed to coercive measures with the highest percentage among patients with organic psychiatric disorders (ICD-10 F0) (28.0%). Coercive measures were applied a mean 5.4 times per case and lasted a mean 9.7 h each. The incidence and duration of coercive measures varied highly between different diagnostic groups and different hospitals. Use of detailed guidelines for seclusion and restraint was associated with a lower incidence of coercive measures.
  
  
  CONCLUSIONS
  Data interpretation should consider numerous confounding factors such as case mix and hospital characteristics. Suggestions on how to cope with ethical and technical problems in the processing of large multi-site data sets in routine clinical use are made.
authors.affiliation: Centre of Psychiatry Weissenau, University of Ulm, 88214, Ravensburg-Weissenau, Germany. tilman.steinert@zfp-weissenau.de
authors.forename: Tilman
authors.initials: T
authors.lastname: Steinert
authors.forename: Veronika
authors.initials: V
authors.lastname: Martin
authors.forename: Manfred
authors.initials: M
authors.lastname: Baur
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bohnet
authors.forename: Rita
authors.initials: R
authors.lastname: Goebel
authors.forename: Gottfried
authors.initials: G
authors.lastname: Hermelink
authors.forename: Rita
authors.initials: R
authors.lastname: Kronstorfer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kuster
authors.forename: Beate
authors.initials: B
authors.lastname: Martinez-Funk
authors.forename: Martin
authors.initials: M
authors.lastname: Roser
authors.forename: Albrecht
authors.initials: A
authors.lastname: Schwink
authors.forename: Wolfram
authors.initials: W
authors.lastname: Voigtländer
mesh_terms: D003068:Coercion; D004282:Documentation; D004358:Drug Therapy; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index