Factors Related to Drug Treatment Refusal in a Forensic Hospital

Predictors of improvement in maximum security forensic hospital patients

“…Treatment refusal is also reported to be common among manic patients (Zito, Routt, & Mitchell, 1985); however, patients diagnosed as having a bipolar disorder are not evident in large numbers in this population. In our previous study of drug treatment refusal in this population, it was evident that psychotic patients who also had a diagnosis of a personality disorder were more likely to comply with drug treatment (Rodenhauser, Schwenkner, & Khamis, 1987). Attention was drawn to the relationship between drug and alcohol abuse and personality disorders, particularly antisocial personality disorders (Koenigsberg et al, 1985).…”

“…Based on the likelihood of multiple diagnoses, chronicity, institutionalization, inconsistent compliance with treatment, and a less favorable response to treatment, it is predictable that patients with schizophrenic disorders would remain hospitalized longer than those with other diagnoses. Treatment refusal is particularly common in this population (Rodenhauser, Schwenkner, & Khamis, 1987) and among schizophrenic patients in general (Marder, et al, 1983;Van Putten, Crumpton, & Yale, 1976;Zito, Routt, & Mitchell, 1985). Treatment refusal is also reported to be common among manic patients (Zito, Routt, & Mitchell, 1985); however, patients diagnosed as having a bipolar disorder are not evident in large numbers in this population.…”

“…Studies of the differences between voluntary and involuntary civil admission status (Gove & Fain, 1977;Okin, 1986;Zwerling, Karasu, Plutchik, & Kellerman, 1975) suggest that commitment is neither detrimental to treatment nor necessarily associated with chronicity and nonresponsiveness to treatment (Okin, 1986). An example of difficulty with interpretation can be drawn from our study of drug treatment refusal among maximum security forensic hospital patients in which treatment refusal was common (35%) and was associated with a significantly longer length of hospitalization (LOH) in comparison with drug compliant patients (Rodenhauser, Schwenkner, & Khamis, 1987). Enforced medication did not, however, shorten the LOH of the refuser group.…”

“…Attention to the relationships between factors of a clinical or legal nature and behaviors of the criminally committed or detained population has gained momentum in recent years (Glaser, 1985;Mowbray, 1979;Rosner, Wiederlight, & Wieczorek, 1985;Rodenhauser, Schwenkner, & Khamis, 1987;Rodenhauser & Khamis, in press;Stokman & Heiber, 1980). Although emphases vary widely, efforts have been focused particularly on the establishment of patterns and relationships that can enhance prevention, prediction, and approaches to treatment.…”

The right to refuse treatment in Oregon: A two‐year statewide experience

“…Persistent refusers, referred to TRP three or more times, were more likely to be schizophrenic and to have had more seclusions, self abusive behavior, and larger doses of medication. Rodenhauser et al (1985) expanded his data on patients refusing medication in a maximum security forensic hospital in Ohio. In 44 months, at a 110 bed hospital, there were 147 incidents of medication refusal lasting greater than 1 week.…”