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Clinical Practice and Epidemiology in Mental Health

, 4:27

First Online: 17 November 2008Received: 10 December 2007Accepted: 17 November 2008

Abstract

BackgroundSelf-directed and other violence as well as subsequent coercive interventions occur in a substantial proportion of patients with personality disorders during in-patient treatment. Different strategies may be required to reduce coercive interventions for patients of different diagnostic groups.

MethodsWe specialised one of our acute admission wards in the treatment of personality disorders and adjustment disorders ICD-10 F4 and F6. Patients are not transferred to other acute wards in case of suicidal or violent behaviour. Violent behaviour and coercive interventions such as seclusion or restraint were recorded in the same way as in the rest of the hospital. We recorded the percentage of subjects affected by diagnostic group and average length of an intervention in the year before and after the change in organisational structure.

ResultsThe total number of coercive interventions decreased by 85% both among patients with an F4 and those with an F6 primary diagnosis. Violent behaviours decreased by about 50%, the proportion of involuntary committed patients decreased by 70%.

ConclusionThe organisational change turned out to be highly effective without any additional cost of personnel or other resources.

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Autor: Tilman Steinert - Frank Eisele - Ulla Goeser - Stefan Tschoeke - Carmen Uhlmann - Peter Schmid

Fuente: https://link.springer.com/







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