ArticleChild and adolescent psychiatry and mental health2024
Children and adolescents at risk for seclusion and restraint in inpatient psychiatric treatment: a case control study.
Article in Child and adolescent psychiatry and mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Experiences of restrictive practices in child and adolescent mental health inpatient care: an integrative review.Child and adolescent psychiatry and mental health · 2026Review
- Risk factors for physical restraint use with children and youth in community and inpatient mental health settings in Ontario.Child and adolescent psychiatry and mental health · 2026Article
- About differences in the availability of child and adolescent psychiatric hospital beds across Europe and possible implications for mental health care. Are more or less hospital beds the solution to the youth mental health crisis? : Based on a debate at the 21st International Congress of the European Society for Child and Adolescent Psychiatry, Strasbourg, June 30, 2025.European child & adolescent psychiatry · 2026Article
- Involuntary psychiatric treatment in Reggio Emilia: local findings from the SIEP multicenter study.Frontiers in psychiatry · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
To reduce coercion in acute inpatient child and adolescent psychiatric units, a better understanding of individuals at risk for seclusion and/or restraint (S/R) is needed. We report data on the proportion of patients secluded/restrained and factors associated with higher risk of S/R. Identifying preventative mechanisms through risk stratification upon inpatient admission can aid the training of mental health professionals, and support shaping specific workflows for at-risk populations for example by joint crisis plans or post-coercion review sessions.
methodsA case-control study included all admissions (n = 782) to a department of child and adolescent psychiatry within 36 months between 2019 and 2022. Data on age, sex, out of home care, primary and comorbid ICD-10 diagnoses, length of stay, prior/multiple admissions were compared between admissions with and without S/R using chi square tests for categorical and t-tests for continuous variables. Uni- and multivariate binary logistic regression models were computed.
resultsThe overall proportion of S/R was 12.8% (n = 100). Females (p = 0.001), patients in out of home care (p < 0.001), with prior admission (p < 0.001), Post-traumatic stress disorder (PTSD; p < 0.001) and Borderline personality disorder (BPD; p < 0.001) were at a significantly higher risk of S/R. Length of stay in days (OR 1.01), out of home care (OR 3.85), PTSD (OR 6.20), BPD (OR 15.17), Attention deficit hyperactivity disorder (ADHD)/conduct disorder (OR 4.29), and manic episode/bipolar disorder (OR 36.41) were significantly associated with S/R in multivariate regression.
conclusionsChild and adolescent psychiatric staff should consider risk factors when using coercive measures. Patients with PTSD and/or BPD are the most vulnerable subgroups. Training of professionals and clinical practice need to be adapted in order to prevent the use of S/R and its potential hazards.
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