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Intramuscular pharmacological treatment and mechanical restraint duration in acute psychiatric settings: Implications
Sagit Dahan1, Yosef Hayat1, Esther Bloemhof-Bris1
1Lev HaSharon Mental Health Medical Center, Tzur Moshe, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Background:
Mechanical restraint is used in psychiatric settings despite international efforts to minimize restrictive practices. Intramuscular medication is routinely administered during the restraint episode as rapid tranquillization with the aim of achieving behavioral control and earlier removal, but evidence regarding its effect on restraint duration in psychiatric inpatient settings is lacking.
Aim:
To examine whether intramuscular pharmacological interventions are associated with restraint duration in acute psychiatric wards using standardized dosing.
Methods:
Retrospective observational study examined 155 restraint episodes of 103 patients in closed wards of an Israeli psychiatric hospital (January 2022-December 2024). Data included restraint duration, intramuscular medication administration (antipsychotics, benzodiazepines, combinations), and dosages in standardized Defined Daily Dose units. Analysis employed Mann-Whitney U tests, ANOVA, and Spearman correlations.
Results:
No significant association was found between pharmacological treatment and restraint duration (U = 1200.500, p = .403). Medication type showed no effect (F(2, 132) = 0.132, p = .877). DDD dosage showed no correlation with duration (rs = -0.056, p = .492).
Conclusions:
No significant associations were detected between pharmacological interventions and restraint duration. The null findings may reflect selection bias and unmeasured factors, including nursing assessment processes and other non-pharmacological variables not measured in this study.