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Schizophrenic patients' retrospective attitudes regarding involuntary psychopharmacological treatment and restraint

Published online by Cambridge University Press:  16 April 2020

D Naber ,
T Kircher  and
K Hessel
D Naber
Affiliation:
Psychiatric University Hospital, Martinistr 52, 20246Hamburg
T Kircher
Affiliation:
Department of Psychiatry, University of Munich, Nuβaumstr 7, 80336Munich, Germany
K Hessel
Affiliation:
Department of Psychiatry, University of Munich, Nuβaumstr 7, 80336Munich, Germany
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Summary

The considerable debate about the justification of coercive measures in psychiatry includes medical, ethical, legal and political arguments, patients' subjective experience of involuntary injections or restraint is barely investigated. A semi-structured interview was used to evaluate retrospective attitudes in 40 (32 schizophrenic) patients, treated involuntarily with injection of neuroleptic drugs or restrained. Of these patients, 48% rated these measures as necessary or positive, 23% as negative, and 30% were indifferent. Only patients with good insight into their disease were able to accept the involuntary treatment retrospectively as positive. Reasons for treatment refusal were inadequacy of the measures (58%), negative previous experience with neuroleptic drugs (47%), eg, akathisia, and reservations against the medical system itself (28%). ‘Fear’ and ‘powerlessness’ were the predominant feelings which patients experienced when confronted with coercive measures. Restraint was more disliked than injections. The results support the notion that disease concept and the ability to acknowledge mental illness are major factors influencing a schizophrenic patient's decision to accept of refuse treatment.

Keywords

involuntary treatmentneurolepticsrestraintpatient's attitude
Type
Original article
Information
European Psychiatry , Volume 11 , Issue 1 , 1996 , pp. 7 - 11
Copyright
Copyright © 1996 Elsevier, Paris

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