Greenberg W M, Moore-Duncan L, Herron R
Division of Psychiatry, Bergen Pines County Hospital, Paramus, NJ 07652, USA.
Bull Am Acad Psychiatry Law. 1996;24(4):513-24.
Forced antipsychotic medication procedures are generally perceived to be clinically necessary options, albelt violations of individuals' bodies and autonomy. Previous studies have explored forcibly medicated patients' attitudes concerning these procedures, but as patients were interviewed while still in the hospital, this may have affected their responses. We interviewed consecutively forcibly medicated English-speaking acute-care inpatients after their discharge to the community. The interviews were conducted by telephone by a clinician not involved with their treatment. Of 65 such patients, 7 had already been rehospitalized, 3 could not recall the procedure, and 25 others refused the interview or were not locatable. Of the 30 who were successfully interviewed, only 47 percent had received any forced injections; the remainder had accepted oral medication under duress. Recollecting their experiences, 57 percent professed fear of side effects, 17 percent feared "addiction," and 17 percent objected to others' controlling them. Forty percent recalled feeling angry, 33 percent helpless, 23 percent fearful, 13 percent embarrassed, but 23 percent were relieved. Surprisingly, 60 percent retrospectively agreed with having been coerced, 53 percent stating they were more likely to take medication voluntarily in the future. Other forcibly medicated patients had poorer outcomes, such as rapid readmission or discharge to a state hospital: those patients may have harbored more negative feelings. However, a substantial fraction of the patients who were reached in the community appeared to support having received medication forcibly as inpatients.
强制使用抗精神病药物的程序通常被视为临床上必要的选择,尽管这侵犯了个人的身体和自主权。先前的研究探讨了被强制用药患者对这些程序的态度,但由于患者是在住院期间接受访谈的,这可能影响了他们的回答。我们对出院回到社区的连续接受强制用药的英语急性护理住院患者进行了访谈。访谈由一名未参与其治疗的临床医生通过电话进行。在65名此类患者中,7人已经再次住院,3人记不起该程序,另外25人拒绝访谈或无法找到。在成功接受访谈的30人中,只有47%接受过任何强制注射;其余人在胁迫下接受了口服药物。回忆他们的经历,57%表示害怕副作用,17%害怕“上瘾”,17%反对他人控制他们。40%回忆起感到愤怒,33%感到无助,23%感到害怕,13%感到尴尬,但23%感到宽慰。令人惊讶的是,60%的人事后同意曾受到胁迫,53%的人表示他们未来更有可能自愿服药。其他被强制用药的患者结局较差,如快速再次住院或被转至州立医院:那些患者可能怀有更多负面情绪。然而,在社区中联系到的相当一部分患者似乎支持住院时接受强制用药。