Use of coercive physical measures in a psychiatric ward of a general hospital in Greece.
BACKGROUND
Coercive physical measures are commonly used in psychiatric units throughout the world for the management of severe behaviourally disturbed patients.


OBJECTIVE
The aim of this study was to assess the rates of coercive physical measures (seclusion and restraint) used in psychiatric inpatients in the psychiatric unit of a general hospital in Greece.


METHODS
A retrospective chart review of all admissions to the psychiatric unit of the University General Hospital of loannina during a six-month period was conducted. Differences between patients who were subjected to coercion and patients who did not receive any coercive treatment were statistically analyzed and compared.


RESULTS
Of the total of 282 admissions during the study period, 31 (11.0%) cases had been subjected to some form of coercive physical measures: 9.55% and 1.76% were affected by seclusion and mechanical restraint, respectively (one patient had been subjected to both). The mean duration of any one seclusion and mechanical restraint was 64.9 hours and the mean number of seclusion and restraint per affected case was 3.58. Statistical analysis between the group subjected to coercive measures and the group who was not did not reveal any association with demographic data or diagnosis. Coercive measures were found to be associated only with the type of admission at intake.


CONCLUSIONS
Involuntary admissions were associated with statistically significant higher levels of restraint and seclusion in this patient sample. Strategies that will enhance patients' follow-up are expected to prevent involuntary admissions and reduce the use of coercive measures.
Bilanakis
Nikolaos
N
Department of Psychiatry, General Hospital of Arta, Greece.
Kalampokis
Georgios
G
Christou
Konstantinos
K
Peritogiannis
Vaios
V
D000328:Adult; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D005260:Female; D006115:Greece; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010356:Patient Isolation / Q000523:psychology / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000523:psychology / Q000706:statistics & numerical data*; D013223:Statistics as Topic; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult