Outcome of Voluntary vs Involuntary Admissions in Greece over 2 years after Discharge: A Cohort Study in the Psychiatric Hospital of Attica “Dafni”

Drakonakis, Nektarios; Stylianidis, Stelios; Peppou, Lily Εvangelia; Douzenis, Athanasios; Nikolaidi, Sofia; Tzavara, Chara; Baladima, Charikleia Eirini; Iatropoulou, Georgia Olga; Psarra, Vassiliki; Tsopanaki, Ersi; Barbato, Angelo

doi:10.1007/s10597-021-00865-y

Cited by 10 publications

(7 citation statements)

References 35 publications

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“…Greece is the country in Western Europe with the highest rate of compulsory psychiatric treatments [32][33]34]. In Italy, on the other hand, the reform of the psychiatric system was largely implemented starting from the 1970s thanks to the Basaglia reform [35,36]. The situation in Hong Kong is very different from the others; although it is now part of China, the psychiatric model used is the one adopted in the UK.…”

Section: Resultsmentioning

confidence: 99%

Involuntary Psychiatric Treatment during the Covid-19 Pandemic. An international qualitative study.

Carbone

Knapp

2022

Preprint

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Aims Over the past years, the Covid-19 pandemic has had a profound psychological impact on the world population. Recent studies report that in the first months of the lockdown there was a slight decrease in requests for mandatory psychiatric treatment, while, in contrast, following the second wave, the cases increased. The purpose of this research is to investigate the use of compulsory psychiatric treatments in different national contexts in the first and subsequent phases of the Covid-19 pandemic. Method Nine key people were interviewed (October and December 2021) among mental health care professionals and scholars in four countries: Italy, Greece, China and Chile. People were asked to express their point of view through a narrative interview on their experience about the motivations, diagnoses and management of patients undergoing an involuntary psychiatric hospitalization. Results Data analysis was conducted through Grounded Theory Methodology and highlighted four core themes: a) the culture of psychiatric care services, b) the effect of the pandemic on involuntary hospitalizations, c) exceptional management of hospitalization in order to reduce the spread of infection, d) policies and suggestions for more inclusive mental health treatments. Conclusion During the first wave of the pandemic (March-May 2020), respondents reported a general decrease in the use of involuntary treatments, while a gradual increase was found in the following months. Italy extended compulsory psychic treatment to a group of new users, such as young people and adolescents with acute crises, in other realities the main users are psychiatric patients with chronic psychopathologies.

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Section: Resultsmentioning

confidence: 99%

Involuntary Psychiatric Treatment during the Covid-19 Pandemic. An international qualitative study.

Carbone

Knapp

2022

Preprint

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“…The instruments used in the present study were the Health of the Nation Outcome Scales (HoNOS) and Global Assessment of Functioning (GAF) scales. HoNOS is a brief instrument developed to measure problems in mental health and psychosocial functioning of users of mental health services (Wing et al, 1998) and is routinely used as an outcome measure in clinical practice and research in many countries (James et al, 2018; Pirkis et al, 2005), including Greece (Drakonakis et al, 2021). The instrument consists of 12 items covering the following domains: (1) overactive, aggressive disruptive or agitated behavior, (2) nonaccidental self‐injury, (3) problem drinking or drug‐taking, (4) cognitive problems, (5) physical illness or disability problems, (6) problems associated with hallucinations and/or delusions, (7) problems with depressed mood, (8) other mental and behavioral problems, (9) problems with relationships, (10) problems with activities of daily living, (11) problems with housing and living conditions and (12) problems with occupation and activities.…”

Section: Methodsmentioning

confidence: 99%

“…There has been significant research on the associations of sociodemographic, clinical‐ and treatment‐related factors with admission status. Regarding sociodemographic characteristics, lower education level (Hustoft et al, 2013; Luo et al, 2019; Wynn, 2018), being unemployed (Chang et al, 2013; Lorenzo et al, 2018; Umama‐Agada et al, 2018) or retired (Schmitz‐Buhl et al, 2019), being unmarried or separated/widowed (Canova Mosele et al, 2018; Feeney et al, 2019; Gilhooley et al, 2017) and living alone (Drakonakis et al, 2021; Lorenzo et al, 2018; Van Der Post et al, 2012) have been associated with IA. The findings regarding age (Gilhooley et al, 2017; Maina et al, 2021; Silva et al, 2018) and gender (Curley et al, 2016; Eytan et al, 2013; Umama‐Agada et al, 2018) are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Clinical determinants of involuntary psychiatric hospitalization: A clinical profile approach

et al. 2023

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Objectives The study examines the clinical determinants of involuntary psychiatric hospitalization. Specifically, it investigates whether distinct clinical profiles of hospitalized patients can be discerned, what other characteristics they are linked with, and which profiles predict involuntary admission. Methods In this cross‐sectional multicentre population study, data were collected for 1067 consecutive admissions in all public psychiatric clinics of Thessaloniki, Greece, during 12 months. Through Latent Class Analysis distinct patient clinical profiles were established based on Health of the Nation Outcome Scales ratings. The profiles were then correlated with sociodemographic, other clinical, and treatment‐related factors as covariates and admission status as a distal outcome. Results Three profiles emerged. The “Disorganized Psychotic Symptoms” profile, combining positive psychotic symptomatology and disorganization, included mainly men, with previous involuntary hospitalizations and poor contact with mental health services and adherence to medication, indicating a deteriorating condition and chronic course. Τhe “Active Psychotic Symptoms” profile included younger persons with positive psychotic symptomatology in the context of normal functioning. The “Depressive Symptoms” profile, characterized by depressed mood coupled with nonaccidental self‐injury, included mainly older women in regular contact with mental health professionals and treatment. The first two profiles were associated with involuntary admission and the third with voluntary admission. Conclusions Identifying patient profiles allows the examination of the combined effect of clinical, sociodemographic, and treatment‐related characteristics as risk factors for involuntary hospitalization, moving beyond the variable‐centered approach mainly adopted to date. The identification of two profiles associated with involuntary admission necessitates the development of interventions tailored to chronic patients and younger persons suffering from psychosis respectively.

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“…27,17 This supports arguments for the crucial role of community-based continuity of care for reducing involuntary hospitalizations, something that has been repeatedly documented with data from different regions of the country. 28-30. The very high re-admission rates documented 26 portray a pervasive revolving door process, raising concerns about the efficacy of the mental health service system in dealing with severe and chronic mental health difficulties. On the other hand, the high percentage of involuntary admissions of persons with a first psychotic episode 13,15 indicates system inadequacies in addressing the early stages of severe mental distress and points to the need for early intervention services.…”

Section: Rates Risk Factors and Process Of Involuntary Hospitalizatio...mentioning

confidence: 99%

“…Given the importance of continuity of care in community settings, this might explain the high rates of re-admission. 26 The only follow-up study to date 26 documented significant improvement in symptomatology and functioning from admission to discharge and over the following two years for both voluntarily and involuntarily admitted patients.…”

Section: Rates Risk Factors and Process Of Involuntary Hospitalizatio...mentioning

confidence: 99%

Involuntary psychiatric hospitalizations in Greece: Contemporary research and policy implications

Stylianidis¹,

Georgaca²,

Peppou³

et al. 2023

Psychiatriki

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Outcome of Voluntary vs Involuntary Admissions in Greece over 2 years after Discharge: A Cohort Study in the Psychiatric Hospital of Attica “Dafni”

Cited by 10 publications

References 35 publications

Involuntary Psychiatric Treatment during the Covid-19 Pandemic. An international qualitative study.

Involuntary Psychiatric Treatment during the Covid-19 Pandemic. An international qualitative study.

Clinical determinants of involuntary psychiatric hospitalization: A clinical profile approach

Involuntary psychiatric hospitalizations in Greece: Contemporary research and policy implications

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