Steinert Tilman, Lepping Peter, Gebhardt Ralf-Peter
Zentrum für Psychiatrie Weissenau, Abt. Psychiatrie I der Universität Ulm.
Psychiatr Prax. 2003 Apr;30(3):114-8. doi: 10.1055/s-2003-38602.
Questionnaires with three case summaries have been presented to 143 psychiatrists in Germany and 27 in England. All three case summaries regard patients with schizophrenia who either show risk to themselves or others. The psychiatrists were asked whether they would recommend sectioning and furthermore whether they would recommend treatment against the patient's will. In the case regarding a risk to others there was widespread approval of sectioning and treatment (Germany 85 %, England 93 %) against the patient's will. Significant differences were seen in the cases of risk to the patients themselves with regards to treatment against the patient's will. This was the case with a scenario involving a young man with his first presentation of schizophrenia as well as in the case of a middle aged man presenting with chronic psychotic symptoms and self-neglect (approval in England: 96 % and 93 % respectively, in Germany: 63 % and 59 % respectively, p < 0.001 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.
包含三个病例摘要的问卷已分发给德国的143名精神科医生和英国的27名精神科医生。所有三个病例摘要均涉及对自己或他人有风险的精神分裂症患者。精神科医生被问及是否会建议将患者强制入院治疗,以及是否会建议违背患者意愿进行治疗。在涉及对他人有风险的案例中,普遍赞成违背患者意愿进行强制入院治疗和治疗(德国为85%,英国为93%)。在涉及对患者自身有风险的案例中,在违背患者意愿进行治疗方面存在显著差异。在一个首次出现精神分裂症症状的年轻男性案例以及一个患有慢性精神病症状且自我忽视的中年男性案例中都是如此(英国的赞成率分别为96%和93%,德国分别为63%和59%,两者p值均<0.001)。进行逻辑回归分析时,工作所在国家是决定是否违背患者意愿进行治疗的最重要预测因素。