Suicidality and Hostility following Involuntary Hospital Treatment
#MMPMID27171229
Giacco D
; Priebe S
PLoS One
2016[]; 11
(5
): e0154458
PMID27171229
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BACKGROUND: Psychiatric patients showing risk to themselves or others can be
involuntarily hospitalised. No data is available on whether following
hospitalisation there is a reduction in psychopathological indicators of risk
such as suicidality and hostility. This study aimed to assess changes in
suicidality and hostility levels following involuntary admission and their
patient-level predictors. METHODS: A pooled analysis of studies on involuntary
treatment, including 11 countries and 2790 patients was carried out. Suicidality
and hostility were measured by the Brief Psychiatric Rating Scale. RESULTS: 2790
patients were included; 2129 followed-up after one month and 1864 after three
months. 387 (13.9%) patients showed at least moderate suicidality when
involuntarily admitted, 107 (5.0%) after one month and 97 (5.2%) after three
months. Moderate or higher hostility was found in 1287 (46.1%) patients after
admission, 307 (14.5%) after one month, and 172 (9.2%) after three months.
Twenty-three (1.2%) patients showed suicidality, and 53 (2.8%) patients hostility
at all time-points. Predictors of suicidality three months after admission were:
suicidality at baseline, not having a diagnosis of psychotic disorder and being
unemployed. Predictors of hostility were: hostility at baseline, not having a
psychotic disorder, living alone, and having been hospitalized previously.
CONCLUSIONS: After involuntary hospital admission, the number of patients with
significant levels of suicidality and hostility decreases substantially over
time, and very few patients show consistently moderate or higher levels of these
symptoms. In patients with psychotic disorders these symptoms are more likely to
improve. Social factors such as unemployment and isolation could hamper
suicidality and hostility reduction and may be targeted in interventions to
reduce risk in involuntarily admitted patients.
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