title: Advance directives based on cognitive therapy: a way to overcome coercion related problems.
abstract: OBJECTIVE
  Mental health advance directives (ADs) are potentially useful for bipolar patients due to the episodic characteristic of their disease. The aim of the present study is to evaluate the impact of advance directives based on cognitive therapy (ADBCT) on the number and duration of hospitalizations as well as compulsory admissions and seclusion procedures.
  
  
  METHODS
  Charts of all treatment non-adherent patients and committed patients who wrote their ADs following an ADBCT intervention within a 24 months period prior to the beginning of the study were included. Number and duration of psychiatric hospitalizations for a mood or a psychotic episode as well as compulsory admissions and seclusion procedures were recorded for each patient 2 years before ADBCT and during a follow-up period of at least 24 months.
  
  
  RESULTS
  The number of hospitalizations, the number of compulsory admission procedures and the number of days spent in psychiatric hospital reduced significantly after ADCBT in comparison to the 2 years who preceded this intervention.
  
  
  CONCLUSIONS
  This retrospective data suggest that ADBCT is effective for patients with compliance and coercion problems. However, these results need to be confirmed in randomized controlled trials.
  
  
  CONCLUSIONS
  ADBCT seems to be a useful approach for treatment-non-adherent and previously coerced patients.
authors.affiliation: Geneva University Hospitals, Rue Verte 2, Geneva, Switzerland. yasser.khazaal@hcuge.ch
authors.forename: Yasser
authors.initials: Y
authors.lastname: Khazaal
authors.forename: Anne
authors.initials: A
authors.lastname: Chatton
authors.forename: Natalia
authors.initials: N
authors.lastname: Pasandin
authors.forename: Daniele
authors.initials: D
authors.lastname: Zullino
authors.forename: Martin
authors.initials: M
authors.lastname: Preisig
mesh_terms: D000328:Adult; D032722:Advance Care Planning / Q000458:organization & administration*; D001714:Bipolar Disorder / Q000517:prevention & control / Q000523:psychology; D003068:Coercion; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007258:Informed Consent / Q000523:psychology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008960:Models, Psychological; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D015397:Program Evaluation; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013557:Switzerland