Abstract
The Study aimed to assess clinical and social outcomes following involuntary admissions over 1 year and identify socio-demographic and clinical patient characteristics associated with more or less favourable outcomes. Seven hundred and seventy-eight involuntary patients admitted to one of 22 hospitals in England were assessed within the first week after admission and at 1 month, 3 month and 12 month follow-ups. Outcome criteria were symptom levels, global functioning, objective social outcomes, and subjective quality of life (SQOL). Baseline characteristics and patients’ initial experience were tested as predictors. Symptom levels and global functioning improved moderately. Objective social outcomes showed a small, but statistically significant deterioration, and SQOL a small, but significant improvement at 1 year. In multivariable analyses, admission due to risk to oneself and receiving benefits predicted poorer symptom outcomes. Female gender and higher perceived coercion were associated with better objective social outcomes, whilst higher initial satisfaction with treatment predicted more positive SQOL at follow-ups. Over a 1-year period following involuntary hospital admission, patients on average showed only limited health and social gains. Different types of outcomes are associated with different predictor variables. Patients’ initial experience of treatment, in the form of perceived coercion or satisfaction with treatment, has predictive value for up to a year following the admission.
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References
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Press, Washington, DC
Angermeyer MC, Kuhn L, Goldstein JM (1990) Gender and the course of schizophrenia: differences in treated outcome. Schizophr Bull 16:293–307
Broker M, Rohricht F, Priebe S (1995) Initial assessment of hospital treatment by patients with paranoid schizophrenia: a predictor of outcome. Psychiatry Res 58:77–81
Fitzmaurice GM, Laird NM, Ware JH (2004) Applied longitudinal analysis. Wiley, New York
Galderisi S, Piegari G, Mucci A, Acerra A, Luciano L, Rabasca AF, Santucci F, Valente A, Volpe M, Mastantuono P, Maj M (2009) Social skills and neurocognitive individualized training in schizophrenia: comparison with structured leisure activities. Eur Arch Psychiatry Clin Neurosci 260:305–315
Gardner W, Hoge S, Bennet N, Roth LH, Lidz CW, Monahan J, Mulvey EP (1993) Two scales for measuring patients’ perceptions of coercion during mental hospital admission. Behav Sci Law 11:307–321
Holscher F, Reissner V, Di Furia L, Room R, Schifano F, Stohler R, Yotsidi V, Scherbaum N (2008) Difference between men and women in the course of opiate dependence: is there a telescoping effect? Eur Arch Psychiatry Clin Neurosci 260:235–241
Hoyer G (2000) On the justification for civil commitment. Acta Psychiatr Scand 101:65–71
Kallert T, Glockner M, Schutzwohl M (2008) Involuntary versus voluntary hospital admission: a systematic literature review on outcome diversity. Eur Arch Psychiatry Clin Neurosci 258:195–209
Kallert TW, Priebe S, McCabe R, Kiejna A, Rymaszewska J, Nawka P, Ocvar L, Raboch J, Starkova-Kalisova L, Koch R, Schutzwohl M (2007) Are day hospitals effective for acutely ill psychiatric patients? A European multicenter randomized controlled trial. J Clin Psychiatry 68:278–287
Katsakou C, Bowers L, Amos T, Morriss R, Rose D, Wykes T, Priebe S Coercion and treatment satisfaction among involuntary patients. Psychiatr Serv 61:286–292
Katsakou C, Priebe S (2006) Outcomes of involuntary hospital admission—a review. Acta Psychiatr Scand 114:232–241
Katsakou C, Priebe S (2007) Patients’ experiences of involuntary hospital admission and treatment: a review of qualitative studies. Epidemiol Psichiatr Soc 16:172–178
Kjellin L, Anderson K, Candefjord I, Palmstierna T, Wallsten T (1997) Ethical benefits and costs of coercion in short-term inpatient psychiatric care. Psychiatr Serv 48:1567–1570
Kjellin L, Westrin C-G, Eriksson K, Alexsson-Ostman M (1993) Coercion in psychiatric care. Problems of medical ethics in a comprehensive empirical study. Behav Sci Law 11:323–334
Lehman AF (1996) Measures of quality of life among persons with severe and persistent mental disorders. Soc Psychiatry Psychiatr Epidemiol 31:78–88
Lukoff D, Nuechterlien K, Ventura J (1986) Manual for the expanded brief psychiatric rating scale. Schizophr Bull 13:261–276
Mattox R (2008) No longer bound by stigma. Am J Psychiatry 165:4
McEvoy JP, Applebaum PS, Apperson LJ, Geller JL, Freter S (1989) Why must some schizophrenic patients be involuntarily committed? Compr Psychiatry 30:13–17
Preti A, Tondo L, Sisti D, Rocchi MB, De Girolamo G (2009) Correlates and antecedents of hospital admission for attempted suicide: a nationwide survey in Italy. Eur Arch Psychiatry Clin Neurosci 260:181–190
Priebe S, Fakhoury W (2008) Quality of life. In: Mueser K, Jeste D (eds) The clinical handbook of schizophrenia. Guilford Press, New York
Priebe S, Gruyters T (1994) Patients’ and caregivers’ initial assessments of day-hospital treatment and course of symptoms. Compr Psychiatry 35:234–238
Priebe S, Gruyters T, Heinze M, Hoffmann C, Jakel A (1995) Subjective evaluation criteria in psychiatric care-methods of assessment for research and general practice. Psychitr Prax 22:140–144
Priebe S, Huxley P, Knight S, Evans S (1999) Application and results of the Manchester assessment of quality of life (MANSA). Int J Soc Psychiatry 45:7–12
Priebe S, Jones G, McCabe R, Briscoe J, Wright D, Sleed M, Beecham J (2006) Effectiveness and costs of acute day hospital treatment compared with conventional in-patient care: randomised controlled trial. Br J Psychiatry 188:243–249
Priebe S, Katsakou C, Amos T, Leese M, Morriss R, Rose D, Wykes T, Yeeles K (2009) Patients’ views and readmissions 1 year after involuntary hospitalisation. Br J Psychiatry 194:49–54
Priebe S, Katsakou C, Gloeckner M, Dembinskas A, Fiorillo A, Karastergiou A, Kiejna A, Kjellin L, Nawka P, Onchev G, Raboch J, Schuetzwohl M, Solomon Z, Torres-González F, Wang D, Kallert T (2010) Patients’ views of involuntary hospital admission after one and three months: a prospective study in eleven European countries. Br J Psychiatry 196:179–185
Priebe S, Roeder-Wanner U, Kaiser W (2000) Quality of life in first-admitted schizophrenia patients: a follow-up study. Psychol Med 30:225–230
Priebe S, Watzke S, Hansson L, Burns T (2008) Objective social outcomes index (SIX): a method to summarise objective indicators of social outcomes in mental health care. Acta Psychiatr Scand 118:57–63
Swartz MS, Swanson JW, Wagner HR, Hannon MJ, Burns BJ, Shumway M (2003) Assessment of four stakeholder groups’ preferences concerning outpatient commitment for persons with schizophrenia. Am J Psychiatry 160:1139–1146
Tarrier N, Lewis S, Haddock R et al (2004) Cognitive- behavioural therapy in first-episode and early schizophrenia. Br J Psychiatry 184:231–239
Van Putten T, May P, Marder S, Wittmann LA (1981) Subjective response to antipsychotic drugs. Arch Gen Psychiatry 38:187–190
Acknowledgments
This study was funded by a grant from the Department of Health, United Kingdom (com. no. 0230072). This work was undertaken by the Unit for Social and Community Psychiatry, Barts’ and the London School of Medicine and Dentistry, Queen Mary University of London, and the views expressed in the publication are those of the authors and not necessarily those of the Department of Health. The funding source had no role in the study design and conduct of the study, data collection, management, data analysis, data interpretation, or writing of the report and preparation, review or approval of the manuscript. All authors report no conflicts of interest. The study was supported by the NIHR UK Mental Health Research Network. We are also grateful to all interviewed patients, the supporting staff in all participating organisations, and the research assistants who collected the data.
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Priebe, S., Katsakou, C., Yeeles, K. et al. Predictors of clinical and social outcomes following involuntary hospital admission: a prospective observational study. Eur Arch Psychiatry Clin Neurosci 261, 377–386 (2011). https://doi.org/10.1007/s00406-010-0179-x
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DOI: https://doi.org/10.1007/s00406-010-0179-x