Principles of compulsory psychiatric inpatient treatment

Dmitriev, Andrey; Vinnikova, Irina; Lazko, Natalia; Ospanova, Anna; Gouzenko, Oxana
January 2007
BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1
Academic Journal
Background The objective of the study is to define the general principles of medical and rehabilitation measures in the conditions of involuntary treatment of mentally disordered offenders. Methods Regular clinical follow-ups assessing psychopathological symptoms were performed during the period of compulsory treatment. Results Implementation of compulsory medical measures comprises the complex use of different treatment methods. Biological therapy is usually combined with psychotherapy and social rehabilitation procedures. The priority of a certain treatment method depends on the stage of the disorder. In choosing therapeutic strategies the leading approach should be a clinically substantiated and differentiated approach based upon the clear verification of the present mental disturbances and upon assessing the register of psychopathological disorders including the differentiation of negative and positive symptoms, and of endogenous and psychogenic compounds. Thus, significance of the complex psychological and psychiatric examination increases and makes data obtained by clinicians more precise and objective. Taking into account the tendency to reduce the psychopathological symptoms we can divide the process of the compulsory inpatient treatment into 4 stages: 1) adjustment and diagnosis, 2) intensive treatment and rehabilitation measures, 3) stabilization of the attained effects, and 4) preparation to discharge from inpatient hospitalization. The consecutive implementation of tasks put before each stage allows the physician to allocate adequately the biological and psychosocial methods in the process of treatment. Conclusion Thus, the main principles of treatment and rehabilitation programs for the patients who committed socially dangerous acts are the complexity, clinical substantiation and differentiation of the treatment measures that are implemented in accordance with tasks relevant to the stages of compulsory treatment.


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