Skokou M, Gouma P, Gourzis P
Department of Psychiatry, General University Hospital of Patras, School of Medicine, University of Patras, Rio, Patra.
Department of Child and Adolescent Psychiatry, General Children's Hospital "Agia Sophia", National and Kapodistrian University of Athens, Athens, Greece.
Psychiatriki. 2017 Jul-Sep;28(3):265-273. doi: 10.22365/jpsych.2017.283.265.
Compulsory admissions represent a significant proportion of psychiatric hospitalizations. A wide variation seems to exist internationally regarding legal frameworks, administrative procedures, detention rates and clinical practice. The aim of the present study is to describe qualitative and quantitative features of compulsory admissions in a large administrative area in southwest Greece, in order to identify targets for future research and possible remediation. Involuntary assessments and admissions in the Department of Psychiatry of the University Hospital of Patras were retrospectively assessed, during a 12-month period, for demographic features and data regarding legal procedures. Diagnoses following compulsory first assessment and at discharge were recorded for the patients who were admitted in our department. During the period of observation, 218 compulsory assessments were made, corresponding to 190 patients and resulting in 183 compulsory admissions. Thirty five cases (16.1%) were assessed as not justifying hospitalization and corresponded mainly to the diagnoses of alcohol and/or substance abuse or dependence. Involuntary hospitalizations represented 44.9% of all psychiatric admissions in our department. Diagnosis at first assessment was most frequently psychosis (68.4%). Diagnoses at discharge were most often schizophrenia (52.8%) and bipolar disorder (21.3%). A history of multiple hospitalizations (>5) was observed in 17 (15.8%) patients, whereas 46 patients (42.6%) were hospitalized for the first time, and 13 (11.7%) exhibited their first psychotic episode. Of the 108 patients who were admitted in our department, 88 (81.5%) declared that they did not wish to attend the court hearing, 7 (6.5%) were not able to attend due to severe health condition, and only 13 (12.0%) actually presented in court. Concluding, current situation regarding legal procedures, involuntary admissions and mental health care in Greece is rather far from satisfying. Future directions should include the systematic recording of mental health care parameters, such as compulsory hospitalizations, as well as efforts to improve these parameters and the existing legal framework and procedures.
强制入院占精神病住院治疗的很大比例。在法律框架、行政程序、拘留率和临床实践方面，国际上似乎存在很大差异。本研究的目的是描述希腊西南部一个大行政区强制入院的定性和定量特征，以便确定未来研究的目标和可能的补救措施。对帕特雷大学医院精神科在12个月期间的非自愿评估和入院情况进行回顾性评估，以了解人口统计学特征和法律程序数据。记录在我们科室入院的患者在首次强制评估时和出院时的诊断。在观察期间，进行了218次强制评估，涉及190名患者，最终有183人被强制入院。35例（16.1%）被评估为无住院必要，主要诊断为酒精和/或药物滥用或依赖。非自愿住院占我们科室所有精神科住院的44.9%。首次评估时最常见的诊断是精神病（68.4%）。出院时最常见的诊断是精神分裂症（52.8%）和双相情感障碍（21.3%）。17名（15.8%）患者有多次住院史（>5次），46名患者（42.6%）是首次住院，13名（11.7%）出现首次精神病发作。在我们科室入院的108名患者中，88名（81.5%）表示他们不想参加法庭听证会，7名（6.5%）因健康状况严重无法参加，只有13名（12.0%）实际出庭。总之，希腊目前在法律程序、非自愿入院和精神卫生保健方面的情况远不能令人满意。未来的方向应包括系统记录精神卫生保健参数，如强制住院情况，以及努力改善这些参数和现有的法律框架及程序。
