Related Experiment Video
Updated: Dec 7, 2025
09:12
The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
72.1K
Shared decision making, aggression, and coercion in inpatients with schizophrenia
Johannes Hamann1, Miriam John1, Fabian Holzhüter1
1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, München, Germany.
Summary
Shared decision making (SDM) benefits patients with involuntary admission or aggression similarly to others. However, SDM did not reduce aggression or coercive measures in psychiatric inpatients.
Area of Science:
- Psychiatry
- Clinical Psychology
- Health Services Research
Background:
- Investigating the impact of shared decision making (SDM) on psychiatric patients, particularly those with involuntary admission or aggression.
- Examining the relationship between coercive measures, patient aggression, and perceived involvement in treatment decisions.
- Addressing the need for effective interventions in acute psychiatric settings.
Purpose of the Study:
- To determine if shared decision making (SDM) has comparable effects for patients with involuntary admission or aggression versus those without.
- To assess whether SDM interventions can reduce patient aggression and the use of coercive measures.
- To investigate the impact of coercion on patients' perceived involvement in their treatment decisions.
Main Methods:
- Utilized data from the cluster-randomized SDM-PLUS trial involving 305 inpatients with schizophrenia or schizoaffective disorder.
- Compared an SDM intervention group with a treatment-as-usual control group across 12 acute psychiatric wards.
- Retrospectively collected data on patient aggression and coercive measures from patient records.
Main Results:
- Patients with involuntary admission or aggression experienced similar benefits from SDM regarding perceived involvement, adherence, and satisfaction.
- Aggression and coercive measures were infrequent during the study phase and primarily occurred early in the inpatient stay.
- The SDM intervention did not significantly reduce patient aggression or the use of coercive measures; prior coercion did not predict perceived involvement.
Conclusions:
- Shared decision making (SDM) appears equally beneficial for diverse patient groups in acute psychiatric care.
- Current SDM interventions may not directly decrease aggression or coercive measures during short inpatient stays.
- Future research should explore early-phase SDM interventions and long-term effects of participatory approaches.
Related Concept Videos
01:29Psychological and Sociocultural Causes of Schizophrenia
355
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
355
01:08Obedience
35.0K
According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
35.0K
01:26Psychosis: Goals of Pharmacotherapy
356
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
356
01:30Psychosurgery
275
Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
275
01:28Psychosis and Antipsychotic Drugs: Overview
668
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
668
01:28Drug Therapy
184
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
184