Margetić Branimir, Aukst Margetić Branka, Ivanec Dragutin
Neuropsychiatric Hospital "Dr. Ivan Barbot", Jelengradska 1, 44317, Popovača, Croatia,
Psychiatr Q. 2014 Dec;85(4):405-16. doi: 10.1007/s11126-014-9299-1.
The use of restraints is a controversial issue even though legal regulations may seem straightforward. Our aims were to evaluate the forensic patients' opinions on certain aspects of restraining and to compare these opinions with the current legal norms. Inpatients with schizophrenia or schizoaffective disorder at the Department of Forensic Psychiatry in Popovača, Croatia, were asked the following questions about the use of mechanical restraints: (a) Should the patients' family be informed about the use of restraints? (b) Should the physician ask the patient whether to inform the family about the use of restraints? (c) Can the use of restraints be a kind of punishment for intentionally aggressive behavior toward people in their environment? and (d) Should restraints be used if the patient requests to be restrained? The patients were assessed according to the Temperament and character inventory and Positive and Negative Symptom Scale. Fifty-four forensic patients with a history of serious offences were included in the study. Their average age was 44.7 (± 8.39) years and the mean duration of their treatment was 6.6 (± 5.08) years. There was no predominant opinion on sharing the information with the family, but there was a relationship between the opinions and psychopathology and personality. Regardless of the patients' mental state and personality, the opinions on the voluntary use of restraints and the use of restraints as punishment for intentionally aggressive behavior were mainly positive. The patients' opinions suggest a need for the implementation of more specific guidelines in the area of forensic psychiatry.
尽管法律法规看似明确，但使用约束措施仍是一个有争议的问题。我们的目的是评估法医鉴定患者对约束措施某些方面的看法，并将这些看法与现行法律规范进行比较。在克罗地亚波波瓦察法医精神病学系，我们询问了患有精神分裂症或分裂情感性障碍的住院患者以下关于使用机械约束措施的问题：(a) 是否应将约束措施的使用告知患者家属？(b) 医生是否应询问患者是否告知家属约束措施的使用情况？(c) 约束措施的使用是否可以作为对患者对周围人故意攻击行为的一种惩罚？以及(d) 如果患者要求被约束，是否应使用约束措施？根据气质和性格量表以及阳性和阴性症状量表对患者进行评估。54名有严重犯罪史的法医鉴定患者纳入了研究。他们的平均年龄为44.7（±8.39）岁，平均治疗时长为6.6（±5.08）年。对于是否与家属分享信息没有占主导地位的意见，但这些意见与精神病理学和人格之间存在关联。无论患者的精神状态和人格如何，对于自愿使用约束措施以及将约束措施作为对故意攻击行为的惩罚的看法主要是积极的。患者的意见表明在法医精神病学领域需要实施更具体的指导方针。
