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Cited by 48Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesElectroconvulsive Therapy Studies

Early detection of risk factors for seclusion and restraint: a prospective study

Georgieva, Irina, Vesselinov, Roumen, Mulder, Cornelis L.·2012·Early Intervention in Psychiatry
DOI 10.1111/j.1751-7893.2011.00330.x
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Abstract

Aim: The study aims to examine the predictive power of static and dynamic risk factors assessed at admission to an acute psychiatric ward and to develop a prediction model evaluating the risk of seclusion and restraint. Methods: Over 20 months, data on demographic and clinical characteristics, psychosocial functioning, level of insight, uncooperativeness, and use of coercive measures were collected prospectively on 520 patients at admission. Logistic regression analysis was used to develop a prediction model. The magnitude of the predictive power of this model was estimated using receiver operating characteristic analysis. Results: The prediction model contained one static predictor (involuntary commitment) and two dynamic predictors (psychological impairment and uncooperativeness), with a high predictive power (receiver operating characteristic area under the curve = 0.83). The final risk model classified 72% of the patients correctly, with a higher sensitivity rate (80%) than specificity rate (71%). Conclusion: Early assessment of patients' psychological impairment and uncooperativeness can help clinicians to recognize patients at risk for coercive measures and approach them on time with preventive and less restrictive interventions. Although this simple, highly predictive model accurately predicts the risk of seclusion or restraint, further validation studies are needed before it can be adopted into routine clinical practice.

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Crossref · 10.1111/j.1751-7893.2011.00330.x

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  • Once a person was admitted as an involuntary patient they were more likely to be subject to use of coercive treatment modalities such as restraint and seclusion than people admitted on a voluntary basis.

    “A similar cycle of coercive care provision may also be evident during admission, with the available literature indicating that once a person was admitted as an involuntary patient they were more likely to be subject to use of coercive treatment modalities such as restraint and seclusion than people admitted on a voluntary basis (34,76–88), and may be more likely to display aggressive behaviours (”

    From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [80]

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Authors
Georgieva, I., Vesselinov, R., & Mulder, C. L.
Affiliations
  • Erasmus MC (NL)
  • New Bulgarian University (BG)
Corresponding author
Georgieva, Irina
ORCID
Venue
Early Intervention in Psychiatry
Publisher
Wiley
Published
2012-01-25
Volume
6
Issue
4
Pages
415-422
ISSN
  • 1751-7885 (ISSN-L)
  • 1751-7893
DOI
10.1111/j.1751-7893.2011.00330.x
OpenAlex
W2129250339
Cited by
48
References
66
Citations by year
2026: 1 · 2025: 4 · 2024: 5 · 2023: 7 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 7 · 2016: 3 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 2
FWCI
3.26
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Early Intervention in Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
seclusion, physical restraint, coercive measures, risk prediction model, acute psychiatric inpatients, involuntary admission, psychological impairment, psychosocial functioning
MeSH terms
Adolescent, Adult, Mental Disorders, Cooperative Behavior, Female, Humans, Male, Middle Aged, Patient Isolation, Prospective Studies, Psychiatric Department, Hospital, Psychiatric Status Rating Scales, Restraint, Physical, Risk Factors, ROC Curve, Sensitivity and Specificity

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