title: [Involuntary psychiatric hospital admissions: a comparison between five hospitals in three German federal states].
abstract: BACKGROUND
  There is considerable variance in involuntary psychiatric hospital admission rates both in Europe and Germany. In a prospective comparison between five hospitals in three German federal states we assessed and analyzed involuntary psychiatric hospital admissions, including the patient's perspective.
  
  
  METHODS
  All involuntarily admitted patients were assessed by an independent researcher. Clinical data, patient and psychiatrist views were documented with different instruments including the McArthur admission experience survey.
  
  
  RESULTS
  In this study 104 out of 244 involuntarily admitted patients gave informed consent. We found considerable differences between study centres concerning involuntary admission quotas (3.2-25.8% of all hospital admissions) and involuntary admission rates (16.6-97.6 per year per 100,000 inhabitants). Hospitals in the state of Baden-Württemberg had the lowest involuntary admission rates while they were highest in Bavaria. In Baden-Württemberg involuntarily admitted patients were more likely to suffer from chronic schizophrenia, they were more severely ill and experienced the involuntary hospital admission as more strenuous. There were no differences between centres concerning frequency of dangerous behavior or self-harm.
  
  
  CONCLUSIONS
  We found a high variance across regions concerning the reasons for, frequencies and legal basis of involuntary hospital admissions. Regional differences of legal frameworks and service organization can explain this only to a limited amount. Transparency, legal certainty and reflection of stakeholder roles are a future necessity. Furthermore, there is a need for stringent compliance with legal regulations and coherent documentation.
authors: Bezirkskrankenhaus Kempten, Akademisches Lehrkrankenhaus der Universität Ulm, Freudental 1, 87435, Kempten (Allgäu), Deutschland, peter.brieger@extern.uni-ulm.de.
authors: P
authors: P
authors: Brieger
authors: P
authors: P
authors: Kling Lourenço
authors: T
authors: T
authors: Steinert
authors: G
authors: G
authors: Längle
authors: U
authors: U
authors: Lemke
authors: S C
authors: SC
authors: Herpertz
authors: D
authors: D
authors: Croissant
authors: T
authors: T
authors: Becker
authors: R
authors: R
authors: Kilian
mesh_terms: D000328:Adult; D017677:Age Distribution; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D003617:Dangerous Behavior; D005260:Female; D005858:Germany; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D017678:Sex Distribution
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