Tilman Steinert

..The clinical practice concerning the use of coercive measures in psychiatry should be compared...

..Within the last decade, many studies on violence have been published. The results are misinterpreted sometimes...

..A systematic review should take into account epidemiological, clinical, ethical, and legal aspects...

..Decisions have to be made under time pressure, there is often an immediate threat to life, the intervention is rather difficult to carry out against a patient's will, and the same dilemma repeats itself continuously within some days...

..Using his experience during this process, he makes some critical comments on the current methods of developing evidence-based treatment recommendations...

..The results yield some evidence that the change from traditional leadership models to the physician-nurse shared leadership model may have advantages in the management of psychiatric hospitals...

..There is evidence for beneficial effects of a training of power and balance on the frequency of falls in residential homes...

..To investigate the incidence of coercive measures in standard psychiatric care in different psychiatric hospitals...

..Different strategies may be required to reduce coercive interventions for patients of different diagnostic groups...

..Both respect of the patient's autonomy, effective treatment (beneficence) and avoiding of harm (non-maleficence) are ethically desirable...

..2). We conclude that exposure to traumatic events in the biography severely enhances the risk of revictimization and retraumatization during inpatient treatment...

..The state of the art in these areas is presented. Ethical considerations and questions of adequateness have a significant effect...

..To compare the clinical management of typical scenarios by using three case vignettes in a substantial number of European countries...

..Further research should provide empirical data and more definite criteria for indications of compulsive measures to achieve a common ethical framework for those critical decisions across Europe...

..In comparison, the American Journal of Psychiatry, the Archives of General Psychiatry and the British Journal of Psychiatry have been publishing a higher percentage of original articles, particularly randomised controlled trials...

..PRELIMINARY RESULTS: A pilot study demonstrated that about 9 % of all admitted patients have been exposed to coercive measures in a subset of the participating hospitals. The variance between the hospitals was rather high...

..001 for both). When a logistic regression was performed the country of work was the most important predictive factor in deciding whether or not to treat a patient against his will...

..Associations between voluntariness of treatment, success of treatment, and number of hospital admissions should be examined...

..Psychiatrists should be asked which neuroleptic they would prefer for themselves and their relatives in the case of first manifestation of schizophrenia...

..What is required is combined treatment with medications and psychotherapeutic measures flanked by a range of social aid groups and rehabilitation measures...

..After professional status, multivariate analyses revealed older age as the most significant variable for support of involuntary treatment. Frequency of experience with mentally ill persons were only weak predictors or not significant...

..The purpose of this study was to examine associations between the voluntary or coercive nature of patients' participation in inpatient treatment and the short-term outcome of inpatient treatment for patients with schizophrenia...

..The aim of this study was to identify quantitative data on the use of seclusion and restraint in different countries and on initiatives to reduce these interventions...

....

..This study intended to standardizedly assess the use of mechanical restraint and seclusion across German and Swiss hospitals...

..Assessment of patients' subjective experiences of an admission to a psychiatric hospital...

..It can be concluded that a stringent documentation, an evaluation and reflection of coercive measures can help to assume quality in the process of coercive measures...

..This study compared the restrictiveness of these interventions from patients' point of view...

..In a psychopathological view, SP were all together more similar to the imprisoned non-sexual delinquent VP than to the SF...

..This study was designed to examine patients' help-seeking contacts and the delays on their pathways to psychiatric care in Germany...

..The least restrictive alternative is recommended. Evidence about what kind of intervention is least restrictive is only scarcely available. Up to now, no randomized controlled trial (RCT) on this subject has been conducted...

..However, patients with long DUP made their first contact with helpers significantly later after the beginning of positive symptoms than patients with short DUP...

..There were no significant differences between patients and staff.Conclusions Psychiatric patients are as motivated as staff for offers about smoking cessation. There is a need for therapeutic offers...

....

..To give an overview about definitions, practice and effects of joint crisis plans in psychiatry...

..We examined whether associations between severity of psychopathological symptoms, patients' aggressive behaviour and coercive measures would be found...

..CONCLUSION: DUP can be regarded as an useful predictor of outcome in schizophrenia. However, further research is required to confirm these results in long-term studies...

..There is good evidence for the existence of psychotic symptoms among patients with dissociative disorders. However, in clinical practice this differential diagnosis is rarely considered...

..To identify attitudes about involuntary admission and treatment in mental health professionals and lay-people and to compare results between England and Germany...

..Large cohort analyses (N > 8000) have shown that all-cause and cardiovascular mortality is no greater with sertindole than with risperidone or olanzapine...

..Attempts to reduce high utilisation of psychiatric inpatient care by targeting the critical time of hospital discharge have been rare...

..Patients can be classified into adherence groups that are of predictive value for long-term patient outcome...