Clinic for Psychiatry and Psychotherapy I, Ulm University, Ulm, Germany.
Centers for Psychiatry Suedwuerttemberg, Ravensburg, Germany.
PLoS One. 2022 Aug 31;17(8):e0264046. doi: 10.1371/journal.pone.0264046. eCollection 2022.
To examine whether the pandemic in 2020 caused changes in psychiatric hospital cases, the percentage of patients exposed to coercive interventions, and aggressive incidents.
We used the case registry for coercive measures of the State of Baden-Wuerttemberg, comprising case-related data on mechanical restraint, seclusion, physical restraint, and forced medication in each of the State's 31 licensed hospitals treating adults, to compare data from 2019 and 2020.
The number of cases in adult psychiatry decreased by 7.6% from 105,782 to 97,761. The percentage of involuntary cases increased from 12.3 to 14.1%, and the absolute number of coercive measures increased by 4.7% from 26,269 to 27,514. The percentage of cases exposed to any kind of coercive measure increased by 24.6% from 6.5 to 8.1%, and the median cumulative duration per affected case increased by 13.1% from 12.2 to 13.8 hrs, where seclusion increased more than mechanical restraint. The percentage of patients with aggressive incidents, collected in 10 hospitals, remained unchanged.
While voluntary cases decreased considerably during the pandemic, involuntary cases increased slightly. However, the increased percentage of patients exposed to coercion is not only due to a decreased percentage of voluntary patients, as the duration of coercive measures per case also increased. The changes that indicate deterioration in treatment quality were probably caused by the multitude of measures to manage the pandemic. The focus of attention and internal rules as well have shifted from prevention of coercion to prevention of infection.
探讨 2020 年大流行是否导致精神病院病例、接受强制性干预的患者比例和攻击事件发生变化。
我们使用巴登-符腾堡州的强制性措施病例登记册，该登记册包含了该州 31 家成人精神病治疗许可医院中每例机械约束、隔离、身体约束和强制用药的与病例相关数据，以比较 2019 年和 2020 年的数据。
成人精神病学的病例数从 105782 例降至 97761 例，下降了 7.6%。非自愿病例的比例从 12.3%上升到 14.1%，强制性措施的绝对数量从 26269 例增加到 27514 例，增加了 4.7%。暴露于任何类型强制性措施的病例比例从 6.5%上升到 8.1%，增加了 24.6%，每个受影响病例的累积持续时间中位数增加了 13.1%，从 12.2 小时增加到 13.8 小时，其中隔离的增加超过了机械约束。在 10 家医院收集的攻击事件患者比例保持不变。
虽然大流行期间自愿病例数量大幅下降，但非自愿病例略有增加。然而，暴露于强制性措施的患者比例增加不仅是由于自愿患者比例下降，因为每个病例的强制性措施持续时间也增加了。表明治疗质量恶化的变化可能是由于多种大流行管理措施造成的。关注的重点和内部规则也从预防强制转变为预防感染。
