Kjellin Lars, Høyer Georg, Engberg Marianne, Kaltiala-Heino Rittakerttu, Sigurjónsdóttir Maria
Psychiatric Research Centre, P.O.Box 1613, Orebro, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 2006 Mar;41(3):241-7. doi: 10.1007/s00127-005-0024-0. Epub 2006 Jan 19.
International variation in compulsory admissions to psychiatric care has mainly been studied in terms of civil commitment rates. The objectives of this study were to compare and analyse the levels of perceived coercion at admission to psychiatric in-patient care among the Nordic countries and between centres within these countries, in relation to legal prerequisites and clinical practice.
From one to four centres each in Denmark, Iceland, Norway, Finland and Sweden, a total of 426 legally committed and 494 formally voluntarily admitted patients were interviewed within 5 days from admission.
The proportion of committed patients reporting high levels of perceived coercion varied among countries (from 49% in Norway to 100% in Iceland), and in Sweden, only, among centres (from 29 to 90%). No clear variations in this respect were found among voluntary patients. A wide concept of coercion in the Civil Commitment Act and no legal possibility of detention of voluntary patients were associated to low levels of perceived coercion at admission among committed patients.
For committed patients, differences in national legal prerequisites among countries were reflected in differences in perceived coercion. The results from Sweden also indicate that local care traditions may account for variation among centres within countries.
精神病护理强制入院的国际差异主要是从民事收容率方面进行研究的。本研究的目的是比较和分析北欧国家之间以及这些国家内部各中心在精神病住院护理入院时的感知强制水平，以及与法律前提条件和临床实践的关系。
丹麦、冰岛、挪威、芬兰和瑞典各有一至四个中心，在患者入院后5天内，共对426名法定收容患者和494名正式自愿入院患者进行了访谈。
报告感知强制水平高的收容患者比例在各国有所不同（从挪威的49%到冰岛的100%），并且仅在瑞典，各中心之间也存在差异（从29%到90%）。在自愿入院患者中未发现这方面的明显差异。《民事收容法》中宽泛的强制概念以及对自愿入院患者没有法律拘留可能性，与收容患者入院时较低的感知强制水平相关。
对于收容患者，各国国家法律前提条件的差异反映在感知强制的差异上。瑞典的结果还表明，当地护理传统可能是各国国内各中心之间存在差异的原因。
