Steinert Tilman, Bergbauer Gabriele, Schmid Peter, Gebhardt Ralf Peter
Department of Psychotherapy, Center for Psychiatry Weissenau, Department of Psychiatry I, University of Ulm, Ulm, Germany.
J Nerv Ment Dis. 2007 Jun;195(6):492-6. doi: 10.1097/NMD.0b013e3180302af6.
Seclusion and restraint represent adverse experiences that cause negative attitudes against psychiatric treatment and psychopathologic sequels such as posttraumatic stress disorder. We examined 117 consecutive admissions with schizophrenia, with an average of 8.7 previous admissions. Positive and Negative Syndrome Scale and Global Assessment of Functioning were obtained at admission and discharge, and traumatic events in the biography were recorded using the Posttraumatic Diagnostic Scale. Twenty-four men (42.9%) and 18 women (29.0%) had experienced seclusion or restraint in their psychiatric history. Seclusion or restraint during the present admission was best predicted in a logistic regression model by physical aggressive behavior [odds ratio (OR), 11.5] and the Positive and Negative Syndrome Scale hostility item at admission (OR, 23.6). Seclusion or restraint ever in the psychiatric history, however, was mostly associated with lifetime exposure to life-threatening traumatic events (OR, 7.2). We conclude that exposure to traumatic events in the biography severely enhances the risk of revictimization and retraumatization during inpatient treatment.
隔离和约束代表着不良经历，会导致对精神科治疗产生负面态度以及出现诸如创伤后应激障碍等精神病理后遗症。我们对117例连续入院的精神分裂症患者进行了研究，这些患者平均之前有过8.7次入院经历。在入院时和出院时获取了阳性和阴性症状量表以及功能总体评定量表，并使用创伤后诊断量表记录了患者生平中的创伤事件。24名男性（42.9%）和18名女性（29.0%）在其精神科病史中经历过隔离或约束。在逻辑回归模型中，通过躯体攻击行为[比值比（OR），11.5]和入院时阳性和阴性症状量表中的敌意项目（OR，23.6）能够最好地预测本次入院期间的隔离或约束情况。然而，精神科病史中曾经历过隔离或约束，大多与终生暴露于危及生命的创伤事件有关（OR，7.2）。我们得出结论，生平中暴露于创伤事件会严重增加住院治疗期间再次受侵害和再次遭受创伤的风险。
