title: Psychiatric patients' perception of physical restraint.
abstract: OBJECTIVE
  To investigate psychiatric patients' subjective perception during and after belt fixation.
  
  
  METHODS
  All patients who were involuntarily admitted and physically restrained at a psychiatric intensive care unit within an 18-month study period were analysed. Ratings were obtained at four visits when questioning was possible.
  
  
  RESULTS
  Within a heterogeneous diagnostic sample of 47 patients, only 12 patients were eligible to participate during belt fixation. After cessation of fixation, eight patients lacked any memory of restraint, while 36 could be questioned. Visual analogue scale median scores indicated powerlessness and depressiveness rather than anxiety and aggression. Patients' acceptance of the coercive measure was significantly higher (P = 0.003), while patients' memory was significantly lower than expected (P < 0.001). About 50% of the patients documented high perceived coercion, and post-traumatic stress disorder (PTSD) could be supposed in a quarter of the restrained individuals. Subjective perceptions concerning fixation showed no significant changes over time. Results showed high interindividual variability.
  
  
  CONCLUSIONS
  Visual analogue scale revealed that belt fixation seemed to be forgotten or accepted in the majority of patients, probably due to psychiatric intensive care, psychopharmacological treatment and clinical improvements. The responses of a quarter of the patients assessed before discharge may be in accordance with symptoms of PTSD.
authors.affiliation: Department of Psychiatry and Psychotherapy, Clinical Division of Biological Psychiatry, Medical University of Vienna, Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Fugger
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Institute of Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Gleiss
authors.affiliation: Department of Psychiatry and Psychotherapy, Clinical Division of Biological Psychiatry, Medical University of Vienna, Vienna, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Baldinger
authors.affiliation: Department of Psychiatry and Psychotherapy, Clinical Division of Biological Psychiatry, Medical University of Vienna, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Strnad
authors.affiliation: Department of Psychiatry and Psychotherapy, Clinical Division of Biological Psychiatry, Medical University of Vienna, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Kasper
authors.affiliation: Department of Psychiatry and Psychotherapy, Clinical Division of Biological Psychiatry, Medical University of Vienna, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Frey
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D003068:Coercion; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D010465:Perception / Q000502:physiology*; D011446:Prospective Studies; D012149:Restraint, Physical / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology
keywords: aggression; clinical aspects; coercion; insight; post-traumatic stress disorder