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Quality of Life and Functioning One Year After Experiencing Accumulated Coercive Events During Psychiatric Admission
Stephen Shannon1, Eric Roche1, Kevin Madigan1
1Mr. Shannon, Dr. Feeney, and Prof. Murphy are with the Department of Psychiatry, and Mr. Madigan is with the Institute of Leadership, Royal College of Surgeons in Ireland, Dublin (e-mail: stshanno@gmail.com ). Mr. Shannon is also with the Mental Health Commission, Dublin, where Dr. Devitt is affiliated. Dr. Feeney and Mr. Madigan are also with Cluain Mhuire Mental Health Service, where Dr. Roche and Dr. Dolan are affiliated. Dr. Renwick is with the Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, London. Dr. O'Donoghue is with Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia. A poster reporting results of this study was presented at the European Congress on Violence in Clinical Psychiatry, Ghent, Belgium, October 23-26, 2013. An oral presentation of this study was delivered at the European Psychiatric Association's epidemiology and social psychiatry section meeting, Ulm, Germany, May 21-24, 2014.
Objectives:
The study aimed to determine the number of accumulated coercive events experienced by patients during inpatient admission, the patients' functioning and quality of life (QOL) one year after discharge, and associations between these variables and patient characteristics and between follow-up outcomes and number of accumulated coercive events.
Methods:
A prospective cohort study was undertaken at three community services and an independent hospital in Ireland (N=162). Accumulated coercive events scores were based on patients' legal status, perceived coercion, and exposure to physical restraint, seclusion, or forced medication.
Results:
Most (68%) experienced at least one coercive event. Lower functioning predicted more coercive events. At follow-up, the mean subjective QOL score was 63% of the highest possible score, objective QOL improved for 15% of participants, and functioning improved for 70%. Accumulated coercive events did not predict these outcomes.
Conclusions:
Coercive events during psychiatric admission appeared unrelated to functioning and QOL at follow-up.
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