Factors Associated With Physical Restraints in a Psychiatric Unit in Japan: a Retrospective Study.

Area of Science:

• Psychiatry
• Clinical Psychology
• Medical Sociology

Background:

• Physical restraint (PR) is a controversial intervention in psychiatric care.
• Understanding factors influencing PR use and duration is crucial for improving patient safety and treatment.
• Limited research exists on PR in Japanese psychiatric settings.

Purpose of the Study:

• To identify demographic, clinical, and treatment-related factors associated with the use of physical restraint (PR).
• To determine factors influencing the duration of PR in a Japanese psychiatric emergency unit.

Main Methods:

• Retrospective review of 1308 first-time admissions to a psychiatric emergency unit (2014-2021).
• Data included patient demographics, diagnoses (ICD-10), and psychotropic medication at admission.
• Logistic and multiple regression analyses were employed to identify factors associated with PR use and duration.

Main Results:

• 30.5% of patients (n=399) received PR. Male sex, treatment at the study hospital, and specific diagnoses (F3, F4-9) were associated with PR use.
• PR duration was associated with older age groups (50-69, ≥70), disability pension status, F1 and F4-9 diagnoses, and specific medication doses.
• Higher chlorpromazine equivalent doses correlated with longer PR duration, while more mood stabilizers were linked to shorter durations.

Conclusions:

• Identifying specific patient and treatment factors can inform strategies to reduce PR use and duration.
• This study provides valuable insights into PR utilization in a Japanese psychiatric context.
• Further research could explore targeted interventions based on identified risk factors.