title: Risk factors of coercion among psychiatric inpatients: a nationwide register-based cohort study.
abstract: Reducing the use of coercion among patients with mental disorders has long been a political priority. However, risk factors for coercive measures have primarily been investigated in smaller studies. To reduce the use of coercion, it is crucial to identify people at risk which we aim to do in this first large-scale study.
  
  
  
  A cohort study was conducted among all psychiatric inpatients in Denmark, following 112,233 individuals during 1999-2014. Data from Danish registers were analysed using logistic regression for repeated measures.
  
  
  
  24,594 inpatients were exposed to a coercive measure (21.9%). Clinical characteristics were the foremost predictors of coercion and patients with organic mental disorder had the highest increased risk of being subjected to a coercive measure (OR = 5.56; 95% CI = 5.04, 6.14). The risk of coercion was the highest in the first admission and decreased with the number of admissions (all p < 0.001). The following socioeconomic variables were associated with an increased risk of coercion: male sex, unemployment, lower social class and immigrants from low and middle income countries (all p < 0.001). Early retirement and social relations, such as being married and having children, reduced the risk of being subjected to coercive measure (all p < 0.05).
  
  
  
  From our nationwide data, we identified a broad range of risk factors associated with coercive measures. Our findings can assist researchers in identifying patients at risk of coercion and thereby help targeting new coercion reduction programs.
authors.affiliation: Mental Health Centre Frederiksberg, Copenhagen University Hospital, Ndr. Fasanvej 57, Frederiksberg, 2000, Copenhagen, Denmark. christoffer.torgaard.thomsen@regionh.dk.|Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark. christoffer.torgaard.thomsen@regionh.dk.
authors.forename: Christoffer
authors.identifier: 0000-0003-4308-1907
authors.initials: C
authors.lastname: Thomsen
authors.affiliation: Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Liis
authors.initials: L
authors.lastname: Starkopf
authors.affiliation: Psychiatric Research Unit, Region Zealand, Denmark.
authors.forename: Lene Halling
authors.initials: LH
authors.lastname: Hastrup
authors.affiliation: Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Per Kragh
authors.initials: PK
authors.lastname: Andersen
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
authors.affiliation: Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Michael Eriksen
authors.initials: ME
authors.lastname: Benros
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Coercion; Epidemiology; Inpatient; Psychiatry; Risk factors