Subjective distress after seclusion or mechanical restraint: one-year follow-up of a randomized controlled study.

Objective: Patients who participated in a randomized controlled trial comparing subjective distress and traumatic impact after seclusion or mechanical restraint were interviewed about the coercive measure about one year later.

Methods: Between May and December 2006, patients were interviewed about one year after experiencing seclusion or mechanical restraint as an inpatient. Items from the Coercion Experience Scale (CES) were used in the original and the follow-up studies to assess distress on a 5-point scale, with higher scores indicating greater distress.

A randomized controlled comparison of seclusion and mechanical restraint in inpatient settings.

Objective: No evidence is available on the relative restrictiveness of seclusion and mechanical restraint, although guidelines recommend use of the least restrictive intervention. This study compared the restrictiveness of these interventions from patients' point of view.

Methods: Data were collected from three general psychiatric admission units in South Germany.

[RCT on discharge planning for high utilisers of mental health care: conduct and quality of the intervention].

Objective: To evaluate feasibility of a structured discharge planning intervention for high utilisers of mental health care developed in a multicentre RCT.

Methods: Data of N = 241 participants (discharge and 3-month follow-up) allocated to the intervention group are analysed with regard to the intervention's quality of implementation, acceptance, and changes in needs.

Results: The intervention was well accepted among patients and staff.

"Coercion Experience Scale" (CES)--validation of a questionnaire on coercive measures.

Background: Although the authors of a Cochrane Review on seclusion and mechanical restraint concluded that "there is a surprising and shocking lack of published trials" on coercive interventions in psychiatry, there are only few instruments that can be applied in trials. Furthermore, as main outcome variable safety, psychopathological symptoms, and duration of an intervention cannot meet the demand to indicate subjective suffering and impact relevant to posttraumatic stress syndromes. An instrument used in controlled trials should assess the patients' subjective experiences, needs to be applicable to more than one intervention in order to compare different coercive measures and has to account for the specific psychiatric context.

[Subjective patient experience of psychiatric admissions].

Objective: Assessment of patients' subjective experiences of an admission to a psychiatric hospital.

Methods: Subjective experiences of psychiatric admissions were recorded with a semi-structured interview in 72 fairly representative in-patients. Patients' satisfaction with treatment was recorded with the ZUF-8 questionnaire.

Feasibility of randomized controlled trials on seclusion and mechanical restraint.

Background: In psychiatry seclusion and mechanical restraint are most commonly used in the management of violence and self-directed aggression. Both interventions are considered as efficacious and indispensable. Yet, these measures can have deleterious effects on patients.