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Schizophrenic patients' retrospective attitudes regarding involuntary psychopharmacological treatment and restraint

Published online by Cambridge University Press:  16 April 2020

D Naber ,
T Kircher  and
K Hessel
D Naber
Affiliation:
Psychiatric University Hospital, Martinistr 52, 20246Hamburg
T Kircher
Affiliation:
Department of Psychiatry, University of Munich, Nuβaumstr 7, 80336Munich, Germany
K Hessel
Affiliation:
Department of Psychiatry, University of Munich, Nuβaumstr 7, 80336Munich, Germany
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Summary

The considerable debate about the justification of coercive measures in psychiatry includes medical, ethical, legal and political arguments, patients' subjective experience of involuntary injections or restraint is barely investigated. A semi-structured interview was used to evaluate retrospective attitudes in 40 (32 schizophrenic) patients, treated involuntarily with injection of neuroleptic drugs or restrained. Of these patients, 48% rated these measures as necessary or positive, 23% as negative, and 30% were indifferent. Only patients with good insight into their disease were able to accept the involuntary treatment retrospectively as positive. Reasons for treatment refusal were inadequacy of the measures (58%), negative previous experience with neuroleptic drugs (47%), eg, akathisia, and reservations against the medical system itself (28%). ‘Fear’ and ‘powerlessness’ were the predominant feelings which patients experienced when confronted with coercive measures. Restraint was more disliked than injections. The results support the notion that disease concept and the ability to acknowledge mental illness are major factors influencing a schizophrenic patient's decision to accept of refuse treatment.

Keywords

involuntary treatmentneurolepticsrestraintpatient's attitude
Type
Original article
Information
European Psychiatry , Volume 11 , Issue 1 , 1996 , pp. 7 - 11
Copyright
Copyright © 1996 Elsevier, Paris

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References

Angst, JBattegay, RBente, DDas Dokumentationssystem der Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie (AMP) Arzneim-Forsch/Drug Res 19 1969 399–405Google Scholar
Arcuni, OJGhazi, AVoluntary and involuntary schizophrenic patient admissions on the same general hospital psychiatric unit Gen Hosp Psychiatry 11 1989 393–396CrossRefGoogle ScholarPubMed
Cournos, FMc Kinnon, KStanley, BOutcome of involuntary medication in a state hospital system Am J Psychiatry 148 1991 489–494Google Scholar
Cournos, FMcKinnon, KAdams, CA comparison of clinical and juidical procedures for reviewing requests for involuntary medication in New York Hosp Community Psychiatry 39 1988 851–855Google ScholarPubMed
David, ABuchanan, AReed, AAlmeida, OThe assessment of insight in psychosis Br J Psychiatry 161 1992 599–602CrossRefGoogle ScholarPubMed
Finzen, AHaug, HJBeck, ALuethy, DHilfe wider Willen BonnPsychiatrie Verlag 1993Google Scholar
Fisher, WARestraint and seclusion Am J Psychiatry 151 1994 15841591Google ScholarPubMed
Harris, GTRice, MEPreston, DLStaff and patient perceptions of the least restrictive alternatives for the short-term control of disturbed behavior J Psychiatry Law 17 1989 239263CrossRefGoogle Scholar
Grove, WRFain, TAComparison of voluntary and committed psychiatric patients Arch Gen Psychiatry 34 1977 669–676Google Scholar
Hoge, SKAppelbaum, PSLawlor, TA prospective, multicenter study of patients' refusal of antipsychotic medication Arch Gen Psychiatry 1990 47 949956CrossRefGoogle ScholarPubMed
Kane, JQuitkin, FRifkin, AWegner, JRosenberg, GBorenstein, MAttitudinal changes of involuntary committed patients following treatment Arch Gen Psychiatry 1983 40 374377CrossRefGoogle ScholarPubMed
Marder, SRMebane, AChien, CWinslade, WJSwann, Evan Putten, TA comparison of patients who refuse and consent to neuroleptic treatment Am J Psychiatry 1983 140 470472Google ScholarPubMed
McEvoy, JPAland, JWilson, WHGuy, WHawkins, LMeasuring chronic schizophrenic patients' attitudes toward their illness and treatment Hosp Community Psychiatry 1981 32 856858Google Scholar
Naber, DWalther, AKircher, THayek, DHolzbach, RSubjective effects of neuroleptics predict complianceGaebel, W,Awad, RPrediction of Neuroleptic Treatment Outcome in Schizophrenia — Concepts and Methods HeidelbergSpringer 1994 8598CrossRefGoogle Scholar
Schmied, KErnst, KIsolierung und Zwangseinweisung im Urteil der betroffenen Patienten und des Pflegepersonals Arch Psychiatr Nervenkr 233 1983 211222CrossRefGoogle Scholar
Svensson, BHansson, LPatient satisfaction with inpatient psychiatric care. The influence of personality traits, diagnosis and perceived coercion Acta Psychiatr Scand 1994 90 379384CrossRefGoogle ScholarPubMed
Van Putten, TWhy do schizophrenic patients refuse to take their drugs? Rach Gen Psychiatry 1974 31 6772CrossRefGoogle ScholarPubMed
Van Putten, TCrumptom, EYale, CDrug refusal in schizophrenia and the wish to be crazy Arch Gen Psychiatry 1976 33 14431446CrossRefGoogle ScholarPubMed
Zito, JMCraig, TJWanderling, JNew York under the rivers decision: an epidemiologic study of drug treatment refusal Am J Psychiatry 1991 148 904909Google ScholarPubMed
Zito, JMRoutt, WWMitchel, JERoerig, JLClinical characteristics of hospitalized psychotic patients who refuse antipsychotic drug therapy Am J Psychiatry 1985 142 822826Google ScholarPubMed
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