title: Involuntary commitment and detainment in adolescent psychiatric inpatient care.
abstract: OBJECTIVE
  To evaluate whether adolescents committed to psychiatric inpatient care are the most disturbed, and whether psychosocial factors other than psychiatric symptoms are associated with commitment to and detainment in psychiatric care among adolescents.
  
  
  METHODS
  The case histories of 187 13- to 17-year-old adolescents consecutively admitted to the study clinic were scrutinized with the help of a structured data collection form. Psychiatric, demographic and family-related characteristics of those referred involuntarily (n = 93) and voluntarily (n = 94), and those detained involuntarily (n = 42) and treated on a voluntary basis (n = 145) were compared.
  
  
  RESULTS
  Involuntary referral and involuntary detainment were associated with psychotic symptoms, temper tantrums and breaking property, involuntary referral also with violent and hostile behaviours and suicidal ideation and talk. They were not associated to family adversities, previous treatment history or sociodemographic factors. The risk for being committed when presenting with aggressive behaviours was greater in girls.
  
  
  CONCLUSIONS
  Involuntary referral and detainment in adolescents is associated with symptom severity, and not with aspects of the adolescent's living conditions. This is in agreement with the legislation. Gender bias resulting in girls' greater risk of being involuntarily committed if displaying aggressive behaviours may be an ethical and legal problem.
authors.affiliation: Department of Adolescent Psychiatry, Tampere University Hospital, 33380, Pitkäniemi, Finland, merihe@uta.fi.
authors.forename: Riittakerttu
authors.initials: R
authors.lastname: Kaltiala-Heino
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000296:Adolescent Psychiatry / Q000706:statistics & numerical data*; D000374:Aggression / Q000523:psychology; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006302:Health Services Research / Q000706:statistics & numerical data; D006760:Hospitalization / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013406:Suicide, Attempted / Q000523:psychology
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