Therapeutic Body Wraps in Swiss public adult acute inpatient wards. A retrospective descriptive cohort study

Abstract

Introduction Many patients suffering from serious mental illness experience severe anxiety and those with psychosis often report the feeling of their bodies falling apart. While it is believed that these patients benefit from therapeutic body wraps (TBWs), the use of this adjunct therapy has rarely been studied in adult patients. Aims The aim of this study was to obtain descriptive statistics on the clinical, social-demographic and institutional reality of TBW therapy in Swiss public adult inpatient wards. Methods Retrospective data related to a cohort of 172 adult inpatients were retrieved from records of two public hospitals. Correlations between TBW and the prescriptions of lorazepam were explored. Results TBWs were primarily used for patients diagnosed with either schizophrenia, schizotypal, delusional and other non-mood psychotic disorders or mood disorders. Patients had, on average, four psychiatric hospitalizations, and in 30% of the cases, TBWs were offered during the first hospitalization. Moreover, TBWs were mostly practiced by nurses. Body wraps were potentially associated with a reduction in both anxiolytic and neuroleptic drugs. Discussion/Implication for practice Based on our results, TBW might contribute to the clinical management of anxiety by nurses. The efficacy of TWB regarding anxiety has yet to be investigated in a randomized controlled trial.

“It's the First Time I Feel as One”. Patients' Experience of Therapeutic Body Wraps in Swiss Public Adult Inpatient Psychiatric Wards

“…This is due to the fact that the inpatient stays are presently very limited in time and that the therapeutic teams are reluctant to initiate psychobody approaches that are deemed incompatible with short stays and time consuming for the hospital clinical staff. A quantitative inquiry (Opsommer et al, 2016) showed that TBWs are mainly offered to patients diagnosed either with any of the DSM IV TR diagnostic categories within F20-29 or F30-39 groups, which makes them a potentially difficult target group to include in a study directly following an inward episode. Three persons initially agreed to be interviewed and eventually declined when contacted by the interviewer after the discharge from hospital.…”

“…The patient's entire body, except the face area, is tightly wrapped in wet cold sheets (below 60°F/15°C) and covered by blankets. As documented by Opsommer et al (2016), TBW clinical teams are composed mostly by two psychiatric nurses, a nurse and a psychiatrist and, less frequently, by any of the latter two and a clinical psychologist. Two clinicians take seats on either side of the patient's bed, should the patient wish to communicate.…”

“…Recently, Consoli et al (2010) reported that the adolescent individuals in their sample usually fell asleep once the wrap warmed up. A recent investigation suggested a potential statistical correlation between TBWs and the use of anxiolytics and neuroleptics in adult inpatients (Opsommer et al, 2016).…”

“…However, a recent multiple case study of TBWs in adolescent patients with schizophrenia included some experiential first-hand material (Cohen et al, 2009). The present paper reports on a multiple-case study that accompanied our recent retrospective cohort study (Opsommer et al, 2016) and aimed at providing the first elements to fill the gap due to the lack of data on TBW use for this population.…”

Therapeutic body wraps (TBW) for treatment of severe injurious behaviour in children with autism spectrum disorder (ASD): A 3-month randomized controlled feasibility study

“…In the era of efficient treatment (e.g., antipsychotics; ECT) for adult psychosis, TBW tended to become anecdotal. More recently, TBW was used in adult psychiatric inpatients as an alternative to physical constraints [ 12 ] or to control anxiety [ 13 ]. Interestingly, in the largest recent retrospective study, which included 172 cases, TBW showed potential to reduce the dose of both anxiolytic and antipsychotic drugs [ 13 ].…”