[Voluntariness and coercion in patients with schizophrenia]

Associations between voluntariness of treatment, success of treatment, and number of hospital admissions should be examined.

88 consecutive admissions with ICD-10 F2 disorders were assessed using the PANSS and the GAF at admission and discharge. Voluntariness was assessed regarding admission, hospital stay, medication, time of discharge, and treatment continuation in four degrees for each category.

Voluntariness increased significantly with the number of hospital admissions in women. Outcome measures (PANSS and GAF differences admission/discharge and the respective differences divided by number of inpatient days) were not significantly related to any aspect of voluntariness. Voluntariness was negatively associated with PANSS-scores at admission, but not at discharge. Aggressive behaviour and coercive measures were observed more frequently in patients with aspects of involuntariness.

The short-term success of treatment in acute schizophrenic episodes seems not to be affected by measures of compulsive treatment. There is some evidence that experiences with former inpatient treatment increase the degree of voluntariness in women.