Abstract:
PURPOSE:Participation in medical decisions and taking into account patients' values and preferences are especially important for psychiatric patients who may be treated against their will. The increasing rates of coercive measures and the underlying clinical, ethical, and legal issues highlight the need to examine their use in psychiatry. Although limited congruence in decision-making preferences may be on the basis of these coercive practices, this issue has not been adequately addressed. We explore the relationship between compulsory admissions and congruence in decision-making preferences in mental health settings. METHODS:Cross-sectional study among 107 outpatients with DSM diagnoses of schizophrenia of bipolar disorder using the Control Preference Scale to assess congruence in decision-making experienced and preferred style. History of compulsory admissions was obtained through review of available records. Descriptive statistics and multivariate analyses were used. RESULTS:70% of patients reported experiencing their preferred style of decision-making and 44% patients had history of compulsory admissions. These patients were more autonomous and preferred to take a more active role. The degree of congruence was lower in patients with previous compulsory admissions. The best predictors of compulsory admissions were not having a regular doctor and the unmatched participation preferences. CONCLUSIONS:Patients who experienced a different level of participation in decision-making than desired more frequently had compulsory admissions. We propose to assess participation preferences each time a relevant treatment decision is about to be made and tailor care accordingly. We identified several factors leading to compulsory admissions that can be modified to prevent further coercive measures.
journal_name
Soc Psychiatry Psychiatr Epidemioljournal_title
Social psychiatry and psychiatric epidemiologyauthors
Morán-Sánchez I,Bernal-López MA,Pérez-Cárceles MDdoi
10.1007/s00127-019-01809-4subject
Has Abstractpub_date
2020-05-01 00:00:00pages
571-580issue
5eissn
0933-7954issn
1433-9285pii
10.1007/s00127-019-01809-4journal_volume
55pub_type
杂志文章abstract:PURPOSE:A number of studies have found an ethnic density effect in psychotic disorders, where the incidence for ethnic minorities increases as the neighbourhood proportional ethnic composition decreases [Morgan and Hutchinson, Psychol Med 40:705-709, (2010); Singh, Psychol Med 39:1402-1403, (2009); Schofield et al., Ps...
journal_title:Social psychiatry and psychiatric epidemiology
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pub_type: 杂志文章,多中心研究
doi:10.1007/s001270200005
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pub_type: 杂志文章,随机对照试验
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