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Use of verbal de-escalation in reducing need for mechanical restraint in patients with psychotic disorders during non-voluntary transfers from home to the psychiatric emergency department

Published online by Cambridge University Press:  01 September 2022

E. Miranda Ruiz ,
A. Gonzalez ,
P. Samos ,
M. Bellsola ,
A. Sabate ,
J. Leon ,
M.A. Jerónimo ,
V. Pérez-Solà ,
L.M. Martin  and
D. Corcoles
E. Miranda Ruiz*
Affiliation:
CST, Psychiatry, Barcelona, Spain
A. Gonzalez
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
P. Samos
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
M. Bellsola
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
A. Sabate
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
J. Leon
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
M.A. Jerónimo
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
V. Pérez-Solà
Affiliation:
Parc de Salut Mar, Institut De Neuropsiquiatria I Addiccions, Barcelona, Spain
L.M. Martin
Affiliation:
Hospital del Mar, Psychiatry, Barcelona, Spain
D. Corcoles
Affiliation:
CST, Psychiatry, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Little is known about the need for mechanical restraint during non-voluntary transfers from patient’s homes to the psychiatric emergency department in patients diagnosed with Paranoid Schizophrenia. Although there is no evidence of its efficacy, one of the main tools used for the reduction of mechanical restraints is verbal de-escalation training.

Objectives

The aim is to describe which symptoms predispose to mechanical restrain in patients with Paranoid Schizophrenia transferred in a non-voluntary manner from home to the psychiatric emergency department, and the effect on reducing mechanical restraints after receiving verbal de-escalation training.

Methods

All patients with Paranoid Schizophrenia who, after being visited by a home psychiatry team, have required non-voluntary transfer from their homes to the psychiatric emergency department were selected (N = 442).

Results

Young age, being male, having a poor adherence to treatment, higher scores for de following variables; Excitement, Grandiosity, Suspiciousness, Hostility, Abstract thinking, Motor tension, Uncooperativeness, Poor attention, Lack of insight and Poor impulse control as well as lower scores in motor retardation on the PANSS, are related to a higher frequency of mechanical restrain (P<0,005). Before the verbal de-escalation training, 43.9% of the transferred patients required mechanical restraint, after the training, the need for restraints was reduced to 25.5% (P<0.001).

Conclusions

Training in verbal de-escalation has allowed an important reduction in mechanical restraints in patients with schizophrenia who have required non-voluntary transfers from home to the psychiatric emergency department.

Disclosure

No significant relationships.

Keywords

Emergency psychiatryMechanical retraintVerbal de-escalationtransfers
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S589
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Creative Common License - CCCreative Common License - BY
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.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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