Association between substance use and coercive measures on psychiatric wards

• Published in: Nervenarzt Vol. 93; no. 5; pp. 442 - 449
• Main Authors: Betzler, Felix, Brandt, Ariadne, Heinz, Andreas, Walter, Henrik
• Format: Journal Article
• Language: German
• Published: Germany 01.05.2022
• Subjects: Coercion; Hospitals, Psychiatric; Humans; Mental Disorders - diagnosis; Mental Disorders - psychology; Mental Disorders - therapy; Patient Isolation; Psychiatric Department, Hospital; Restraint, Physical; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Drugs; Alcohol; Cannabis; Intoxication; Mechanical restraints
• ISSN: 1433-0407
• DOI: 10.1007/s00115-021-01181-2

The intention to minimize coercive measures requires a comprehensive understanding of the influencing factors. The aim of the present work was to examine the association between substance use and the use of coercive measures. All coercive measures carried out on acute psychiatric wards of the Charité Campus Mitte in 2019 were examined, with a particular focus on the association with substance use disorders. In 106 cases (92 patients) out of a total of 1232 cases (1131 patients), coercive measures were used, mainly admissions according to PsychKG (94) and BGB (21), more rarely isolation (23) or mechanical restraint (18). Acute intoxication was present in approximately one third of cases with coercive measures and a history of substance use disorder in two thirds, most often with alcohol and/or cannabis. In contrast, 9% of 1232 treatment cases presented with acute intoxication and 36% with substance use disorders in general. The present work delivers empirical data confirming the clinically known association between intoxication and the use of coercive measures.