Increase in coercive measures in psychiatric hospitals in Germany during the COVID-19 pandemic
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
To examine whether the pandemic in 2020 caused changes in psychiatric hospital cases, the percentage of patients exposed to coercive interventions, and aggressive incidents.
Methods
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.
Results
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.
Conclusions
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.
Article activity feed
-
-
SciScore for 10.1101/2022.02.03.22270373: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethics: The Ethics Committee of Ulm University waived the requirement for ethical approval as approval is not required for studies analyzing anonymized data, in accordance with national legislation and institutional requirements. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has the typical limitations of observational studies. Even if it might look rather obvious in the present case, conclusions referring …
SciScore for 10.1101/2022.02.03.22270373: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Ethics: The Ethics Committee of Ulm University waived the requirement for ethical approval as approval is not required for studies analyzing anonymized data, in accordance with national legislation and institutional requirements. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has the typical limitations of observational studies. Even if it might look rather obvious in the present case, conclusions referring to causal attributions remain speculative and are not supported by data. Beyond the presented empirical data, no systematic knowledge is available on the consequences of the COVID-19 pandemic on everyday clinical practice in psychiatric hospitals. Further in-depth qualitative research will be necessary for a deeper understanding of the detrimental consequences of the pandemic situation on different patient groups in psychiatric hospitals, day clinics, and outpatient and rehabilitation services.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
-
