Clinical and demographic differences between voluntary and involuntary psychiatric admissions in a university hospital in Brazil
Open accessAbstract
To assess the frequency of involuntary psychiatric hospitalizations from 2001 to 2008 and to determine associated clinical and socio-demographic characteristics, a retrospective cohort study was conducted. Adult admission data were collected from a university hospital in Brazil. Hospitalizations were classified as voluntary (VH) or involuntary (IH). Groups were compared using chi-square test for categorical variables and Mann-Whitney test for continuous non-parametric variables. The relative risk of certain events was estimated by the odds ratio statistic. Of 2,289 admissions, 13.3% were IH. The proportion of IH increased from 2.5% to 21.2% during the eight year period. IH were more frequently associated with female gender, unmarried status, unemployment, and more than 9 years of schooling. Psychotic symptoms were more common among IH. There were no differences in age, duration of hospitalization, or rate of attendance at first appointment after hospital discharge. Understanding of the characteristics associated with IH is necessary to improve the treatment of psychiatric disorders.
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Some studies found no difference in the clinical effects of involuntary admission.
“In general, these studies found either no difference in the clinical effects of involuntary admission (27,40–45) or greater improvements in clinical symptoms and functioning than for voluntary patients (46,47).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [40]
The Results (page not specified) report no difference between involuntary and voluntary admissions in hospital-stay duration or attendance at the first appointment after discharge. The paper does not report comparable changes in symptoms or functioning, so those findings support only a narrower claim than no difference in clinical effects. (LLM, conf=0.84)
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- Authors
- Chang, T. M. M., Ferreira, L. K., Ferreira, M. P., & Hirata, E. S.
- Affiliations
- Universidade de São Paulo, Brasil
- Universidade de São Paulo (BR)
- Venue
- Cadernos de Saúde Pública
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2013-11
- Volume
- 29
- Issue
- 11
- Pages
- 2347-2352
- ISSN
- 0102-311X (ISSN-L)
- OpenAlex
- W2052667043
- Cited by
- 39
- References
- 18
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 7 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 8 · 2018: 2 · 2017: 3 · 2016: 1 · 2014: 1 · 2013: 1
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Cadernos de Saúde Pública (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Keywords
- involuntary psychiatric admission, psychiatric hospitalization, sociodemographic factors, psychotic symptoms, gender differences, marital status, unemployment, educational attainment, post-discharge follow-up
- MeSH terms
- Adult, Mental Disorders, Brazil, Commitment of Persons with Psychiatric Disorders, Commitment of Mentally Ill, Female, Hospitalization, Hospitals, Psychiatric, Hospitals, University, Humans, Male, Retrospective Studies, Sex Factors, Socioeconomic Factors, Young Adult
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