Mechanical and pharmacological restraints in acute psychiatric wards - why and how are the used?
Psychiatry Research, 2012. | 2012
Restraints had been reported to be common in acute psychiatry, but empirical research is scarce conserning why and how they are used. This study analysed data from patients' first episodes of restraint in three acute psychiatric wards during a 2 -year study period. Logistic regression analysed were used to identify predictors for type and duration of restraint. Distribution of restraint-categories for the 371 restrained patients was: mechanical restraint, 47.2%; mechanical and pharmacological restraint together, 35.2%; and pharmacological restraint, 17.5%. The most common reported reason for restraint was assault (ocurred or imminent). It increased the likelihood of resulting in concomitant pharmacological restraint. Female patients had shorter duration of mechanical restraint than men. Age above 49 and female gender increased the likelihood of pharmacological versus mechanical restraint, whereas being restrained due to assault weakened this association. Episodes with mechanical restraint and coinciding pharmacological restraint lasted longer than mechanical restraint used separately, and were less common among patients with a personality disorder. Diagnoses, age and reason for restraint did independently increase the likelihood for being subjected to specific types of restraint. Female gander predicted type of restraint and duration of episodes.