1ARKIN Mental Health Care, Research Department, Amsterdam, The Netherlands.
Int J Soc Psychiatry. 2014 Mar;60(2):125-33. doi: 10.1177/0020764012470234. Epub 2013 Jan 17.
Compulsory admission to a psychiatric hospital is associated with a three- to fourfold increase in the risk of another compulsory admission. Given the rising numbers of civil detentions in The Netherlands and other European countries, it is important to understand the mechanism behind this association. Our aim is to study the links between opinions about prior psychiatric treatment, insight, service engagement and the risk of (new) civil detentions.
We took a random sample of 252 from the 2,682 patients consecutively coming into contact with two psychiatric emergency teams in Amsterdam between September 2004 and September 2006. We recorded socio-demographic and clinical characteristics, and information about prior involuntary admissions. We interviewed the patients using the Verona Service Satisfaction Scale (Verona-EU), the Birchwood Insight Scale and the Service Engagement Scale. During a two-year follow-up period we noted their use of mental health care facilities.
Patients with a satisfactory score on the Verona-EU had significantly lower odds for civil detentions during follow-up compared to patients with a dissatisfactory score on this scale (OR = 0.3). Level of insight did not influence the risk of detention during follow-up. Furthermore, of the 131 patients admitted involuntarily the year before, one-third looked back on their involuntary admission with unambiguous satisfaction.
More satisfaction with prior treatment seems to reduce the risk of civil detention remarkably. Low levels of satisfaction seem to be mainly dependent on a history of previous involuntary admission. These findings seem to open up a new perspective for diminishing the risk of (new) civil detention by trying to enhance satisfaction with treatment, especially for patients under detention.
强制住院与再次强制住院的风险增加三到四倍有关。鉴于荷兰和其他欧洲国家的民事拘留人数不断增加，了解这种关联的机制非常重要。我们的目的是研究对先前精神科治疗、洞察力、服务参与度的看法与（新的）民事拘留风险之间的联系。
我们从 2004 年 9 月至 2006 年 9 月期间连续接触到阿姆斯特丹两个精神科急诊小组的 2682 名患者中随机抽取了 252 名患者。我们记录了社会人口统计学和临床特征，以及先前非自愿入院的信息。我们使用 Verona 服务满意度量表（Verona-EU）、Birchwood 洞察力量表和服务参与量表对患者进行了访谈。在两年的随访期间，我们记录了他们使用心理健康保健设施的情况。
与 Verona-EU 评分不满意的患者相比，评分满意的患者在随访期间因民事拘留的可能性显著降低（OR=0.3）。洞察力水平并不影响随访期间拘留的风险。此外，在这一年之前，131 名非自愿入院的患者中，三分之一对其非自愿入院感到满意。
对先前治疗的满意度增加似乎显著降低了民事拘留的风险。低水平的满意度似乎主要取决于先前的非自愿入院史。这些发现似乎为通过提高治疗满意度来降低（新的）民事拘留风险开辟了新的视角，尤其是对被拘留的患者。
