Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review

Saya, Anna; Brugnoli, Chiara; Piazzi, Gioia; Liberato, Daniela; Ciaccia, Gregorio Di; Niolu, Cinzia; Siracusano, Alberto

doi:10.3389/fpsyt.2019.00271

Cited by 75 publications

(63 citation statements)

References 58 publications

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“…Since the 1950s, mental health legislations have changed considerably throughout Europe and the world [1,34]. As public attitudes and treatment practices began to shift, many European countries reformed their legal framework for treatment and involuntary admission in order to focus on ensuring the rights and safety of mentally ill patients [1,[34][35][36]. Across many countries, the mental health legislative schemes differ slightly, particularly regarding the criteria for admission, and who authorizes it [35,37,38].…”

Section: Legal Aspectsmentioning

confidence: 99%

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

et al. 2020

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Background.Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.Methods.The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.Results.We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.Conclusions.We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

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Section: Legal Aspectsmentioning

confidence: 99%

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

et al. 2020

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“…Involuntary treatment has been justified by combining public reasons of social security Savulescu, 2012, 2019) with other criteria implemented in different legislations (Saya et al, 2019), such as mental incapacity and non-intrusiveness of the treatment. Remarkably, all these criteria are now challenged by recent international standards for the rights of persons with disabilities, where informed consent to mental health services has been vigorously supported in any case (see United Nations, 2006, art.…”

Section: A Commentary Onmentioning

confidence: 99%

Commentary: The moral bioenhancement of psychopaths

Sirgiovanni

Garasic

2020

Front. Psychol.

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“…Second, the patients' basic characteristics and long-term prognosis were not fully investigated due to administrative restrictions. Though there is similar involuntary treatment/admission in psychiatry worldwide, there is a gap between legislation and practice (26). Therefore, the extent to which this method can expedite clinical decision-making is unclear.…”

Section: Limitationsmentioning

confidence: 99%

Efficient Prediction of Vitamin B Deficiencies via Machine-Learning Using Routine Blood Test Results in Patients With Intense Psychiatric Episode

et al. 2020

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Background: Vitamin B deficiency is common worldwide and may lead to psychiatric symptoms; however, vitamin B deficiency epidemiology in patients with intense psychiatric episode has rarely been examined. Moreover, vitamin deficiency testing is costly and time-consuming, which has hampered effectively ruling out vitamin deficiencyinduced intense psychiatric symptoms. In this study, we aimed to clarify the epidemiology of these deficiencies and efficiently predict them using machine-learning models from patient characteristics and routine blood test results that can be obtained within one hour.Methods: We reviewed 497 consecutive patients, who are deemed to be at imminent risk of seriously harming themselves or others, over a period of 2 years in a single psychiatric tertiary-care center. Machine-learning models (k-nearest neighbors, logistic regression, support vector machine, and random forest) were trained to predict each deficiency from age, sex, and 29 routine blood test results gathered in the period from Results: We found that 112 (22.5%), 80 (16.1%), and 72 (14.5%) patients had vitamin B 1 , vitamin B 12 , and folate (vitamin B 9 ) deficiency, respectively. Further, the machine-learning models were well generalized to predict deficiency in the future unseen data, especially using random forest; areas under the receiver operating characteristic curves for the validation dataset (i.e., the dataset not used for training the models) were 0.716, 0.599, and 0.796, respectively. The Gini importance of these vitamins provided further evidence of a relationship between these vitamins and the complete blood count, while also indicating a hitherto rarely considered, potential association between these vitamins and alkaline phosphatase (ALP) or thyroid stimulating hormone (TSH).

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Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review

Cited by 75 publications

References 58 publications

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

Commentary: The moral bioenhancement of psychopaths

Efficient Prediction of Vitamin B Deficiencies via Machine-Learning Using Routine Blood Test Results in Patients With Intense Psychiatric Episode

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