A systematic literature review on application and effects of forced admissions

van de Ven-Dijkman, Marieke V.; Schoevers, Robert; Sikkens, Erik
January 2007
BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1
Academic Journal
Background The Dutch Association for Psychiatrists is working on a guideline when to decide to use involuntary measures. Therefore, it's necessary to research the (side) effects of forced admission. The main question in a literature research is: What's the effect of forced admission on the course of a psychiatric illness, on the motivation and attitude of patients, and how could it be harmful, or how could the failing to come to forced admission be harmful. Methods A systematic literature research was performed in 4 electronic databases. Results From 4,734 potentially relevant studies we distilled 40 studies. Conclusion Although the available literature has methodological limitations, the conclusion seems justified that forced admission has no influence on the course of the illness, or the therapy adherence after the measure. Possibly, forced admission even has a positive effect on the prognosis and the therapy adherence, besides the prevention of danger, which is the legal base for a coerced hospitalization. The decision not to choose for coerced hospitalization, because of the conviction that a long-term treatment-relationship after the measure will not be possible, for patients who neglect themselves gravely, which causes social abandonment for them, is not supported in the literature. Of course there are negative side-effects of forced admission: each hospitalization means a grave interference in someone's personal life, but this does not seem to differ much between coerced and voluntary patients. In all cases a respectful attitude and explanation about the background and legitimacy of the measure is of main importance for a positive patient's perception.


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