Does the legal status affect the outcome of inpatients with schizophrenia?

Abstract

Background and aims:

Patients suffering from psychotic disorders are the most common to be admitted to psychiatry departments and treated against their will. All patients in this study were included in the international project EUNOMIA, which is focused on the contemporary use of coercive measures in psychiatry. The purpose of this study was to compare the voluntary and involuntary admitted patients, measured as improvement of psychopathology and social functioning.

Methods:

120 involuntary and 18 voluntary patients, who met the criteria for an F2 disorder and subjective felt coercion at the admission measured by the McArthur Scale were included. They were assesed three times, in the first week and at the end of first and third month after admission with Brief Psychiatric Rating Scale - BPRS and Global Assessment of Functioning - GAF Scale. Outcome was defined as a change in the total BPRS and GAF scores between first and third observation.

Results:

There was no significant difference in the total BPRS (voluntary T1 48.6±13.3, T3 35.5±10.2, and involuntary T1 50.5±12.8, T3 32.2±8.6) or GAF (voluntary T1 38.1±14.7, T3 63.6±10.3 and involuntary T1 29.8±12.8, T3 63.6±17.1) changes, (p<0,05). In the lenght of stay both groups significantly differ, voluntary 30.8±15.9 resp. involuntary 51.5±51.6 days.

Conclusions:

Inpatients with schizophrenia who were treated involuntary, improved at the same level as the voluntary ones, however the lenght of hospital stay was shorter by voluntary patients.