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How dangerousness evolves after court-ordered compulsory psychiatric admission: explorative prospective observational cohort study

  • Mark H. de Jong (a1), André I. Wierdsma (a2), Antonius W. B. van Baars (a3), Arthur R. Van Gool (a1) and Cornelis L. Mulder (a4)...
Abstract
Background

Compulsory admission is commonly regarded as necessary and justified for patients whose psychiatric condition represents a severe danger to themselves and others. However, while studies on compulsory admissions have reported on various clinical and social outcomes, little research has focused specifically on dangerousness, which in many countries is the core reason for compulsory admission.

Aims

To study changes in dangerousness over time in adult psychiatric patients admitted by compulsory court order, and to relate these changes to these patients' demographic and clinical characteristics.

Method

In this explorative prospective observational cohort study of adult psychiatric patients admitted by compulsory court order, demographic and clinical data were collected at baseline. At baseline and at 6 and 12 month follow-up, dangerousness was assessed using the Dangerousness Inventory, an instrument based on the eight types of dangerousness towards self or others specified in Dutch legislation on compulsory admissions. We used descriptive statistics and logistic regression to analyse the data.

Results

We included 174 participants with a court-ordered compulsory admission. At baseline, the most common dangerousness criterion was inability to cope in society. Any type of severe or very severe dangerousness decreased from 86.2% at baseline to 36.2% at 6 months and to 28.7% at 12 months. Being homeless at baseline was the only variable which was significantly associated with persistently high levels of dangerousness.

Conclusions

Dangerousness decreased in about two-thirds of the patients after court-ordered compulsory admission. It persisted, however, in a substantial minority (approximately one-third).

Declaration of interest

None.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence: Mark H. de Jong, Yulius Mental Health, Postbus 1001, 3300 BA Dordrecht, The Netherlands. Email: ma.dejong@yulius.nl
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How dangerousness evolves after court-ordered compulsory psychiatric admission: explorative prospective observational cohort study

  • Mark H. de Jong (a1), André I. Wierdsma (a2), Antonius W. B. van Baars (a3), Arthur R. Van Gool (a1) and Cornelis L. Mulder (a4)...
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