title: Do patient and ward-related characteristics influence the use of coercive measures? Results from the EUNOMIA international study.
abstract: OBJECTIVE
  This study aims to identify whether selected patient and ward-related factors are associated with the use of coercive measures. Data were collected as part of the EUNOMIA international collaborative study on the use of coercive measures in ten European countries.
  
  
  METHODS
  Involuntarily admitted patients (N = 2,027) were divided into two groups. The first group (N = 770) included patients that had been subject to at least one of these coercive measures during hospitalization: restraint, and/or seclusion, and/or forced medication; the other group (N = 1,257) included patients who had not received any coercive measure during hospitalization. To identify predictors of use of coercive measures, both patients' sociodemographic and clinical characteristics and centre-related characteristics were tested in a multivariate logistic regression model, controlled for countries' effect.
  
  
  RESULTS
  The frequency of the use of coercive measures varied significantly across countries, being higher in Poland, Italy and Greece. Patients who received coercive measures were more frequently male and with a diagnosis of psychotic disorder (F20-F29). According to the regression model, patients with higher levels of psychotic and hostility symptoms, and of perceived coercion had a higher risk to be coerced at admission. Controlling for countries' effect, the risk of being coerced was higher in Poland. Patients' sociodemographic characteristics and ward-related factors were not identifying as possible predictors because they did not enter the model.
  
  
  CONCLUSIONS
  The use of coercive measures varied significantly in the participating countries. Clinical factors, such as high levels of psychotic symptoms and high levels of perceived coercion at admission were associated with the use of coercive measures, when controlling for countries' effect. These factors should be taken into consideration by programs aimed at reducing the use of coercive measures in psychiatric wards.
authors.affiliation: Department of Psychiatry, 1st Medical School, Charles University, Prague, Czech Republic, luciekalisova@seznam.cz.
authors.forename: Lucie
authors.initials: L
authors.lastname: Kalisova
authors.forename: Jiri
authors.initials: J
authors.lastname: Raboch
authors.forename: Alexander
authors.initials: A
authors.lastname: Nawka
authors.forename: Gaia
authors.initials: G
authors.lastname: Sampogna
authors.forename: Libor
authors.initials: L
authors.lastname: Cihal
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Kallert
authors.forename: Georgi
authors.initials: G
authors.lastname: Onchev
authors.forename: Anastasia
authors.initials: A
authors.lastname: Karastergiou
authors.forename: Valeria
authors.initials: V
authors.lastname: Del Vecchio
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kiejna
authors.forename: Tomasz
authors.initials: T
authors.lastname: Adamowski
authors.forename: Francisco
authors.initials: F
authors.lastname: Torres-Gonzales
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Cervilla
authors.forename: Stephan
authors.initials: S
authors.lastname: Priebe
authors.forename: Domenico
authors.initials: D
authors.lastname: Giacco
authors.forename: Lars
authors.initials: L
authors.lastname: Kjellin
authors.forename: Algirdas
authors.initials: A
authors.lastname: Dembinskas
authors.forename: Andrea
authors.initials: A
authors.lastname: Fiorillo
mesh_terms: D000328:Adult; D003068:Coercion; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D008962:Models, Theoretical; D010465:Perception; D011044:Poland; D011567:Psychiatric Department, Hospital; D012737:Sex Factors
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