Riecher-Rössler A, Rössler W
Zentralinstitut für Seelische Gesundheit, Mannheim.
Fortschr Neurol Psychiatr. 1992 Oct;60(10):375-82. doi: 10.1055/s-2007-999157.
The frequency of compulsory admissions of psychiatric patients is very variable if compared nationally and internationally. In the old Laender of West Germany, between 2.8% (Bremen) and 44.8% (West Berlin) of all psychiatric admissions were compulsory. The range is even broader, if one compares different western countries: while in Denmark the frequency of compulsory admissions is about 5% of all admissions, it is 50-93% in Switzerland. In this paper the reasons for this wide variation are analysed, making a distinction between "true" and "artificial" differences in frequency. Artificial differences are mainly due to insufficient representativity and comparability of the populations studied. True differences on the other hand are mainly a consequence of the differing legislation in the individual countries and of regional differences in administrative regulations, but also of the situation of mental health care. Apart from analysing these patient-independent factors influencing compulsory admission, the characteristics of patients are studied which are associated with a higher risk of compulsory admission. The relation of these patient characteristics with the factors "danger to oneself or others", which are the prerequisites of compulsory admission in most countries, is discussed.
与国内及国际情况相比，精神病患者强制入院的频率差异很大。在原西德的老联邦州，所有精神病入院病例中强制入院的比例在2.8%（不来梅）至44.8%（西柏林）之间。如果比较不同的西方国家，这个范围甚至更广：丹麦强制入院的频率约占所有入院病例的5%，而在瑞士则为50% - 93%。本文分析了这种巨大差异的原因，区分了频率上“真实”和“人为”的差异。人为差异主要是由于所研究人群的代表性和可比性不足。另一方面，真实差异主要是各国立法不同、行政法规存在地区差异以及精神卫生保健状况的结果。除了分析这些影响强制入院的与患者无关的因素外，还研究了与强制入院风险较高相关的患者特征。讨论了这些患者特征与“对自己或他人有危险”这一因素的关系，“对自己或他人有危险”是大多数国家强制入院的前提条件。
