Characteristics of patients frequently subjected to pharmacological and mechanical restraint--a register study in three Norwegian acute psychiatric wards.
This retrospective study from three catchment-area-based acute psychiatric wards showed that of all the pharmacologically and mechanically restrained patients (n=373) 34 (9.1%) had been frequently restrained (6 or more times). These patients accounted for 39.2% of all restraint episodes during the two-year study period. Adjusted binary logistic regression analyses showed that the odds for being frequently restrained were 91% lower among patients above 50 years compared to those aged 18-29 years; a threefold increase (OR=3.1) for those admitted 3 times or more compared to patients with only one stay; and, finally, a threefold increase (OR=3.1) if the length of stay was 16 days or more compared to those admitted for 0-4 days. Among frequently restrained patients, males (n=15) had significantly longer stays than women (n=19), and 8 of the females had a diagnosis of personality disorder, compared to none among males. Our study showed that being frequently restrained was associated with long inpatient stay, many admissions and young age. Teasing out patient characteristics associated with the risk of being frequently restraint may contribute to reduce use of restraint by developing alternative interventions for these patients.
Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway; Division of Mental Health and Addiction, Department of Research and Education, Oslo University Hospital, Ullevål, P.O.Box 4956, Nydalen, N-0424 Oslo, Norway. Electronic address: maria.knutzen@kompetanse-senteret.no.
Maria
M
Knutzen
Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway; Molde University College, P.O. Box 2110, 6402 Molde, Norway.
Stål
S
Bjørkly
Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway; Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004 Drammen, Norway.
Gunnar
G
Eidhammer
Division of Mental Health and Addiction, Department of Research and Education, Oslo University Hospital, Ullevål, P.O.Box 4956, Nydalen, N-0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O.Box 1039, Blindern N-0315, Norway.
Steinar
S
Lorentzen
Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004 Drammen, Norway.
Nina Helen
NH
Mjøsund
Institute of Clinical Medicine, University of Oslo, P.O.Box 1039, Blindern N-0315, Norway.
Stein
S
Opjordsmoen
Unit for Biostatistics and Epidemiology, Oslo University Hospital, Ullevål, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway.
Leiv
L
Sandvik
Division of Mental Health and Addiction, Department of Research and Education, Oslo University Hospital, Ullevål, P.O.Box 4956, Nydalen, N-0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O.Box 1039, Blindern N-0315, Norway.
Svein
S
Friis
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D009664:Norway; D011567:Psychiatric Department, Hospital; D012042:Registries; D012149:Restraint, Physical; D012189:Retrospective Studies; D055815:Young Adult
Acute psychiatry; Coercion; Emergency services