ArticleBMC psychiatry2025
Prevalence and risk factors for seclusion and restraint: results of a retrospective analysis.
Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Gender and other diversity-related factors in psychiatric hospital care: protocol for the participatory mixed-methods PSY-DIVER study.BMC psychiatry · 2026Article
- Implementing modular competence-oriented psychotherapy in inpatient psychiatry: a three-year analysis of restraint and seclusion.BMC psychiatry · 2026Article
- Psychiatric Care Pathways and the Use of Coercion: From Pre-Hospital to Inpatient Settings.Community mental health journal · 2026Article
- Abolition of coercion in psychiatry on the horizon? A descriptive ecologic data study from six European countries.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Association of psychological resilience and social support with subjective coercion experience in hospitalized psychiatric inpatients: a cross-sectional study.Frontiers in public health · 2026Article
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6 authors.
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Abstract
backgroundThe reduction of coercion is a central challenge of inpatient mental health services. Little is known about the use of seclusion and restraint in open-door settings. This work aims to analyse the prevalence and risk factors of coercive measures in open inpatient wards of a Swiss university psychiatric hospital.
methodsThe use of seclusion and restraint was retrospectively analysed between 2017 and 2019. Incidence rate ratios using multivariable Poisson regressions were calculated to determine patient- and hospital stay-related risk factors for coercion.
resultsOf 1764 patients, 293 (16.6%) underwent at least one coercive measure (mostly seclusion) during their stay. The experience of coercive measures was associated with the following factors: male gender (IRR 1.34 [1.26, 1.38], p < 0.001), younger age (IRR 0.97 [0.97, 0.97], p < 0.001), being single or divorced (IRR 1.49 [1.43, 1.60], p < 0.001), diagnoses of organic (IRR 13.43 [13.38, 13.48], p < 0.001), psychotic (IRR 1.79 [1.79, 1.79], p < 0.001), or bipolar (IRR 2.17 [2.16, 2.17], p < 0.001) disorders, receiving disability benefits (IRR 1.92 [1.90, 2.07], p < 0.001), higher number of previous psychiatric hospitalizations (IRR 1.03 [1.03, 1.03], p < 0.001), and higher Health of the Nation Outcome Scales (HoNOS) item 1-scores (overactive, aggressive, or agitated behaviour) at admission 1.27 [1.27, 1.27], p < 0.001). Referrals from the emergency department (ED) (IRR 0.78 [0.77, 0.86], p < 0.001) were associated with a lower risk of coercion.
conclusionsYoung age, being single or divorced, male gender, diagnoses of organic, bipolar, or psychotic disorders, being on disability benefits, and previous psychiatric hospitalizations were identified as risk factors of coercion. The incidence of coercion was lower in ED referrals. Item 1 HoNOS scores at admission might be sufficient for a meaningful assessment of coercion risk. Our results suggest a strong link between aggressive behaviour and the use of coercive measures. Identification of patients at risk should be integrated to coercion reduction programs. The role of institutional and cultural factors influencing the use of coercion should be further investigated.
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