title: Patient characteristics and symptoms associated with perceived coercion during hospital treatment.
abstract: OBJECTIVE
  Large numbers of psychiatric patients either are involuntarily admitted to hospital treatment or feel coerced despite a legally voluntary admission. For ethical and clinical reasons, their perceived coercion should be reduced as far as possible. There is however limited evidence on patient characteristics associated with perceived coercion during hospital treatment. This study aimed to identify i) sociodemographic and clinical characteristics associated with perceived coercion at admission and ii) changes in symptoms and global functioning associated with changes in perceived coercion over time.
  
  
  METHODS
  Three thousand and ninety three in-patients who were involuntarily admitted or felt coerced to hospital treatment despite a legally voluntary admission were recruited in the European evaluation of coercion in psychiatry and harmonization of best clinical practice - EUNOMIA project in 11 European countries. Perceived coercion, global functioning and symptoms were assessed after admission and at a 3-month follow-up.
  
  
  RESULTS
  Involuntary admission, female gender, poorer global functioning and more positive symptoms were associated with higher levels of perceived coercion at admission. Perceived coercion significantly decreased over time, and the improvements in global functioning and positive symptoms were associated with reduction in perceived coercion.
  
  
  CONCLUSIONS
  Female patients perceive more coercion in psychiatric hospital treatment. Effective treatment for positive symptoms and improving patients' global functioning may lead to a reduction in perceived coercion.
authors.affiliation: Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, Italy. andrea.fiorillo@unina2.it
authors.forename: A
authors.initials: A
authors.lastname: Fiorillo
authors.forename: D
authors.initials: D
authors.lastname: Giacco
authors.forename: C
authors.initials: C
authors.lastname: De Rosa
authors.forename: T
authors.initials: T
authors.lastname: Kallert
authors.forename: C
authors.initials: C
authors.lastname: Katsakou
authors.forename: G
authors.initials: G
authors.lastname: Onchev
authors.forename: J
authors.initials: J
authors.lastname: Raboch
authors.forename: A
authors.initials: A
authors.lastname: Mastrogianni
authors.forename: V
authors.initials: V
authors.lastname: Del Vecchio
authors.forename: M
authors.initials: M
authors.lastname: Luciano
authors.forename: F
authors.initials: F
authors.lastname: Catapano
authors.forename: A
authors.initials: A
authors.lastname: Dembinskas
authors.forename: P
authors.initials: P
authors.lastname: Nawka
authors.forename: A
authors.initials: A
authors.lastname: Kiejna
authors.forename: F
authors.initials: F
authors.lastname: Torres-Gonzales
authors.forename: L
authors.initials: L
authors.lastname: Kjellin
authors.forename: M
authors.initials: M
authors.lastname: Maj
authors.forename: S
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D003068:Coercion; D015331:Cohort Studies; D003134:Commitment of Persons with Psychiatric Disorders; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010465:Perception; D011446:Prospective Studies; D012737:Sex Factors