title: [Impact of the Temporaneous Lack of Legal Basis for Involuntary Treatment on the Frequency of Aggressive Incidents, Seclusion and Restraint among Patients with Chronic Schizophrenic Disorders].
abstract: OBJECTIVE
  In the German federal state Baden-Wuerttemberg involuntary medication of detained psychiatric inpatients was unlawful during eight months from July 2012 until February 2013 due to a decision of the Federal Constitutional Court except for emergency situations. We examined whether aggressive incidents and mechanical coercive measures such as seclusion and restraint increased.
  
  
  METHODS
  Routine data of 2.644 cases with schizophrenic and manic disorders in seven psychiatric hospitals were analysed by a pooled cross-section analysis as well as by a longitudinal analysis for the relevant time period and the corresponding period of the preceding year.
  
  
  RESULTS
  The number of mechanical coercive measures and of aggressive incidents increased significantly by over 40 % in the cross-sectional analysis. In the longitudinal analysis which included only patients with admissions in both periods, the increase of both aggressive incidents and coercive measures was over 100 %. Effects on the duration of measures were insignificant.
  
  
  CONCLUSIONS
  The temporaneous impossibility to apply involuntary medication was associated with a significant increase of aggressive incidents, seclusion, and mechanical restraint.
authors.affiliation: Zentrum für Psychiatrie Südwürttemberg, Versorgungsforschung Weissenau.
authors.forename: Erich
authors.initials: E
authors.lastname: Flammer
authors.affiliation: Zentrum für Psychiatrie Südwürttemberg, Versorgungsforschung Weissenau.
authors.forename: Tilman
authors.initials: T
authors.lastname: Steinert
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D002908:Chronic Disease; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence* / Q000639:trends; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012149:Restraint, Physical / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012565:Schizophrenic Psychology; D014600:Utilization Review
chemical_list: D011619:Psychotropic Drugs