Miteva Dimitrina, Georgiadis Foivos, McBroom Lorna, Noboa Vanessa, Quednow Boris B, Seifritz Erich, Vetter Stefan, Egger Stephan T
Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.
Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland; Faculty of Medicine, San Francisco de Quito University, Quito, Ecuador.
Compr Psychiatry. 2022 Jan 31;114:152299. doi: 10.1016/j.comppsych.2022.152299.
Mastery of a language is bound to place of origin; low language proficiency is thus related to migration and cultural differences, all of which influence access to mental health care, treatment and outcomes. Switzerland, being multilingual, allows the disentangling of language proficiency from migration and, to some extent, culture. This study uses propensity score matching to explore how language proficiency relates to help-seeking behaviour, service use, treatment and outcomes in patients with mental health disorders.
We used the first admission of patients admitted to and discharged from an academic psychiatric hospital in Switzerland between January 1st, 2013 and December 31st, 2019, with an observation period of one-year post-discharge (until December 31st, 2020). We paired 2101 patients with low language proficiency to 2101 language proficient patients, balancing baseline sociodemographic and clinical characteristics using propensity score matching.
Patients with low language proficiency had a higher probability of compulsory admission (OR: 1.79, 99%CI: 1.60-2.02); which remained after adjustment for confounders (OR: 1.51; 99%CI: 1.21-1.89). Whilst in treatment, they had higher rates of compulsory medication (OR: 1.73, 99%CI: 1.16-2.59) and seclusion/restraint (OR: 1.87, 99%CI: 1.25-2.79). Furthermore, patients initially admitted voluntarily had a higher probability of being compulsorily retained (OR: 1.74, 99%CI: 1.24-2.46). Both groups showed similar clinical improvement rates and service use parameters.
Our results demonstrate that low language proficiency constitutes a risk factor for coercive measures throughout hospitalisation. The results demonstrate the need for an increase in language sensitivity in psychiatric care.
语言掌握程度与出生地相关；因此，低语言能力与移民及文化差异有关，所有这些都会影响获得心理健康护理、治疗及治疗效果。瑞士是多语言国家，这使得我们能够将语言能力与移民以及在一定程度上与文化区分开来。本研究采用倾向得分匹配法来探究语言能力与心理健康障碍患者的求助行为、服务利用、治疗及治疗效果之间的关系。
我们使用了2013年1月1日至2019年12月31日期间在瑞士一家学术精神病医院住院并出院的患者的首次入院数据，观察期为出院后一年（至2020年12月31日）。我们将2101名低语言能力患者与2101名语言能力熟练的患者进行配对，使用倾向得分匹配法平衡基线社会人口统计学和临床特征。
低语言能力患者被强制入院的可能性更高（比值比：1.79，99%置信区间：1.60 - 2.02）；在对混杂因素进行调整后该情况仍然存在（比值比：1.51；99%置信区间：1.21 - 1.89）。在接受治疗期间，他们接受强制用药的比例更高（比值比：1.73，99%置信区间：1.16 - 2.59）以及被隔离/约束的比例更高（比值比：1.87，99%置信区间：1.25 - 2.79）。此外，最初自愿入院的患者被强制留院的可能性更高（比值比：1.74，99%置信区间：1.24 - 2.46）。两组的临床改善率和服务利用参数相似。
我们的结果表明，低语言能力是整个住院期间采取强制措施的一个风险因素。结果表明在精神科护理中需要提高对语言的敏感性。
