Characteristics of patients frequently subjected to pharmacological and mechanical restraint--a register study in three Norwegian acute psychiatric wards

Maria Knutzen; Stål Bjørkly; Gunnar Eidhammer; Steinar Lorentzen; Nina Helen Mjøsund; Stein Opjordsmoen; Leiv Sandvik; Svein Friis

doi:10.1016/j.psychres.2013.10.024

Characteristics of patients frequently subjected to pharmacological and mechanical restraint--a register study in three Norwegian acute psychiatric wards

Psychiatry Res. 2014 Jan 30;215(1):127-33. doi: 10.1016/j.psychres.2013.10.024. Epub 2013 Oct 28.

Authors

Maria Knutzen¹, Stål Bjørkly², Gunnar Eidhammer³, Steinar Lorentzen⁴, Nina Helen Mjøsund⁵, Stein Opjordsmoen⁶, Leiv Sandvik⁷, Svein Friis⁴

Affiliations

¹ Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway; Division of Mental Health and Addiction, Department of Research and Education, Oslo University Hospital, Ullevål, P.O.Box 4956, Nydalen, N-0424 Oslo, Norway. Electronic address: maria.knutzen@kompetanse-senteret.no.
² Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway; Molde University College, P.O. Box 2110, 6402 Molde, Norway.
³ Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway; Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004 Drammen, Norway.
⁴ Division of Mental Health and Addiction, Department of Research and Education, Oslo University Hospital, Ullevål, P.O.Box 4956, Nydalen, N-0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O.Box 1039, Blindern N-0315, Norway.
⁵ Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004 Drammen, Norway.
⁶ Institute of Clinical Medicine, University of Oslo, P.O.Box 1039, Blindern N-0315, Norway.
⁷ Unit for Biostatistics and Epidemiology, Oslo University Hospital, Ullevål, P.O. Box 4956, Nydalen, N-0424 Oslo, Norway.

PMID: 24230996
DOI: 10.1016/j.psychres.2013.10.024

Abstract

This retrospective study from three catchment-area-based acute psychiatric wards showed that of all the pharmacologically and mechanically restrained patients (n=373) 34 (9.1%) had been frequently restrained (6 or more times). These patients accounted for 39.2% of all restraint episodes during the two-year study period. Adjusted binary logistic regression analyses showed that the odds for being frequently restrained were 91% lower among patients above 50 years compared to those aged 18-29 years; a threefold increase (OR=3.1) for those admitted 3 times or more compared to patients with only one stay; and, finally, a threefold increase (OR=3.1) if the length of stay was 16 days or more compared to those admitted for 0-4 days. Among frequently restrained patients, males (n=15) had significantly longer stays than women (n=19), and 8 of the females had a diagnosis of personality disorder, compared to none among males. Our study showed that being frequently restrained was associated with long inpatient stay, many admissions and young age. Teasing out patient characteristics associated with the risk of being frequently restraint may contribute to reduce use of restraint by developing alternative interventions for these patients.

Keywords: Acute psychiatry; Coercion; Emergency services.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Case-Control Studies
Female
Hospitalization
Humans
Length of Stay
Male
Mental Disorders / psychology*
Middle Aged
Norway
Psychiatric Department, Hospital*
Registries
Restraint, Physical*
Retrospective Studies
Young Adult