title: Mechanical and pharmacological restraints in acute psychiatric wards--why and how are they used?
abstract: Restraint use has been reported to be common in acute psychiatry, but empirical research is scarce concerning why and how restraints are used. This study analysed data from patients' first episodes of restraint in three acute psychiatric wards during a 2-year study period. Logistic regression analyses were used to identify predictors for type and duration of restraint. The distribution of restraint categories for the 371 restrained patients was as follows: mechanical restraint, 47.2%; mechanical and pharmacological restraint together, 35.3%; and pharmacological restraint, 17.5%. The most commonly reported reason for restraint was assault (occurred or imminent). It increased the likelihood of resulting in concomitant pharmacological restraint. Female patients had shorter duration of mechanical restraint than men. Age above 49 and female gender increased the likelihood of pharmacological versus mechanical restraint, whereas being restrained due to assault weakened this association. Episodes with mechanical restraint and coinciding pharmacological restraint lasted longer than mechanical restraint used separately, and were less common among patients with a personality disorder. Diagnoses, age and reason for restraint independently increased the likelihood for being subjected to specific types of restraint. Female gender predicted type of restraint and duration of episodes.
authors.affiliation: Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway. maria.knutzen@kompetanse-senteret.no
authors.forename: Maria
authors.initials: M
authors.lastname: Knutzen
authors.forename: Stål
authors.initials: S
authors.lastname: Bjørkly
authors.forename: Gunnar
authors.initials: G
authors.lastname: Eidhammer
authors.forename: Steinar
authors.initials: S
authors.lastname: Lorentzen
authors.forename: Nina
authors.initials: N
authors.lastname: Helen Mjøsund
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D009664:Norway; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012149:Restraint, Physical; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult