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A Three-Month Follow-Up Study Evaluating Changes in Clinical Profile and Attitudes Towards Involuntary Admission

Published online by Cambridge University Press:  23 March 2020

E. Bainbridge*
Affiliation:
Galway, IrelandGalway, Ireland
B. Hallahan
Affiliation:
National University of Ireland, Department of psychiatry, Galway, Ireland
D. McGuinness
Affiliation:
National University of Ireland, Psychiatry, Galway, Ireland
A. Higgins
Affiliation:
Trinity College Dublin, School of nursing and midwifery, Dublin, Ireland
K. Murphy
Affiliation:
National University of Ireland, Nursing and midwifery, Galway, Ireland
P. Gunning
Affiliation:
National University of Ireland, Biostatistics Department, Galway, Ireland
J. Newell
Affiliation:
National University of Ireland, Biostatistics Department, Galway, Ireland
C. McDonald
Affiliation:
National University of Ireland, Psychiatry, Galway, Ireland
*
*Corresponding author.

Abstract

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Introduction

Involuntary admission and treatment is often a traumatic experience for patients and there is a wide variation in attitudes towards care even when patients are recovered.

Objectives/aims

The purpose of this large prospective study was to identify clinical predictors of attitudes towards care during involuntary admission.

Methods

Three hundred and ninety-one consecutively admitted involuntarily patients to three psychiatric inpatient units over a 30-month period were invited to participate in the study. Comprehensive assessments at admission and 3 months after discharge were attained including measures of symptoms, insight, functioning, attitudes towards involuntary admission and coercive experiences. Multiple linear regression modelling was used to determine the optimal explanatory variables for attitudes towards care.

Results

Two hundred and sixty-three individuals participated at baseline and 156 (59%) successfully completed follow-up assessments. Individuals improved significantly over time clinically and in their attitudes towards their care. At baseline greater insight (P < 0.001) and less symptoms (P = 0.02) were associated with more positive attitudes towards care as was older age (P = 0.001). At follow-up, greater insight (P < 0.001), less symptoms (P = 0.02) and being older (P = 0.04) were associated with more positive attitudes towards care. More positive attitudes towards care at follow-up were associated with greater improvements in insight over time (P < 0.001) and having a diagnosis of an affective psychosis (P = 0.0009).

Conclusions

The best predictors of positive attitudes towards care during and after involuntary admission are illness related factors, such as levels of insight and improvement in insight, rather than service or legislation related factors, such as the use of coercive measures, seclusion and restraint.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV761
Copyright
Copyright © European Psychiatric Association 2016
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