Psychiatria Danubina, Vol. 29 No. 4, 2017.
Original scientific paper
https://doi.org/10.24869/psyd.2017.490
CORRELATES OF INVOLUNTARY ADMISSION: FINDINGS FROM AN ITALIAN INPATIENT PSYCHIATRIC UNIT
Pierfrancesco Maria Balducci
; Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, PG, Italy
Francesco Bernardini
; Department of Psychiatry, Erasme Hospital, Universitè Libre de Bruxelles (ULB), Anderlecht, Belgium
Luca Pauselli
; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
Alfonso Tortorella
; Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, PG, Italy
Michael T. Compton
; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
Abstract
Background: Involuntary admission is challenging in terms of providing the most effective but least restrictive care in accordance with the country’s regulations. A better understanding of correlates of voluntary versus involuntary admission legal status is crucial to improve clinical decision-making and effectiveness of the overall mental health care system.
Subjects and methods: We collected chart-review data pertaining to 848 patients, discharged between June 2011 and June 2014, from an Italian inpatient psychiatric unit. Diverse sociodemographic and clinical variables were collected. Bivariate analyses and binary logistic regression were performed to examine correlates of involuntary admission.
Results: Bivariate analyses showed that involuntary status was related to: the reason for hospitalization, not being on psychiatric medications at admission, and being admitted from another inpatient ward (in particular, from the emergency department). The final regression model identified four main variables independently associated with legal status: being admitted for psychotic features, suicidal behavior, or impulsive behavior, and not being on medication at admission (Nagelkerke pseudo R2=0.15, p<0.001). A strong association with length of stay was also documented.
Conclusions: Understanding the causes and consequences of involuntary admission will enhance the field’s understanding of how to provide the most effective, but least restrictive, psychiatric care.
Keywords
community psychiatry; involuntary admission; mental health; mental illness; risk factors
Hrčak ID:
190610
URI
Publication date:
4.12.2017.
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