Department of Neurology and Psychiatry, Policlinico Umberto I, Sapienza University of Rome, Italy.
Int J Soc Psychiatry. 2013 Sep;59(6):613-8. doi: 10.1177/0020764012450985. Epub 2012 Jun 29.
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Immigrants in Europe appear at higher risk of psychiatric coercive interventions. No studies have investigated this issue in Italy. The aim of this study is to investigate whether the use of physical restraint, compulsory admission and other treatment characteristics differ in immigrated and Italian-born patients admitted to a psychiatric intensive care unit.
One hundred first-generation immigrant patients were compared to 100 age-, gender- and diagnosis-matched Italian-born patients. Subjects were diagnosed according to DSM-IV-TR and rated on the Clinical Global Impression - Severity Scale and the Global Assessment of Functioning. Clinical data and treatment characteristics were collected.
Immigrant patients were more likely to be physically restrained as compared to Italian-born patients (11% vs 3%; χ (2) = 4.92; p = 0.027; RR = 3.67; 95% CI = 1.05-12.7). No differences in the proportion of involuntary treatment were found. Immigrant patients did not receive higher doses of antipsychotics or benzodiazepines, but they had a longer stay in the hospital.
The higher rate of physical restraint among migrants may reflect cultural, ethnic and language differences leading to communication problems between immigrant patients and mental health professionals. Since coercive interventions can be harmful, specific strategies to prevent this phenomenon in immigrants are needed.
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欧洲的移民似乎面临更高的精神科强制性干预风险。目前尚无研究调查意大利的这一问题。本研究旨在调查精神科强化护理病房收治的第一代移民患者与意大利出生患者在使用身体约束、强制入院和其他治疗特征方面是否存在差异。
将 100 名第一代移民患者与 100 名年龄、性别和诊断匹配的意大利出生患者进行比较。根据 DSM-IV-TR 进行诊断，并对临床总体印象-严重程度量表和总体功能评估进行评分。收集临床数据和治疗特征。
与意大利出生患者相比，移民患者更有可能接受身体约束（11%比 3%； χ (2) = 4.92；p = 0.027；RR = 3.67；95% CI = 1.05-12.7）。非自愿治疗的比例没有差异。移民患者没有接受更高剂量的抗精神病药或苯二氮䓬类药物，但他们在医院的住院时间更长。
移民中身体约束的更高比例可能反映了文化、种族和语言差异，导致移民患者与精神卫生专业人员之间存在沟通问题。由于强制性干预可能有害，因此需要针对移民制定具体策略来预防这种现象。
