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Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review

INTRODUCTION: Although informal coercion is frequently applied in psychiatry, its use is discussed controversially. This systematic review aimed to summarize literature on attitudes toward informal coercion, its prevalence, and clinical effects. METHODS: A systematic search of PubMed, Embase, PsycIN...

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Autores principales: Hotzy, Florian, Jaeger, Matthias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149520/
https://www.ncbi.nlm.nih.gov/pubmed/28018248
http://dx.doi.org/10.3389/fpsyt.2016.00197
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author Hotzy, Florian
Jaeger, Matthias
author_facet Hotzy, Florian
Jaeger, Matthias
author_sort Hotzy, Florian
collection PubMed
description INTRODUCTION: Although informal coercion is frequently applied in psychiatry, its use is discussed controversially. This systematic review aimed to summarize literature on attitudes toward informal coercion, its prevalence, and clinical effects. METHODS: A systematic search of PubMed, Embase, PsycINF, and Google Scholar was conducted. Publications were included if they reported original data describing patients’ and clinicians’ attitudes toward and prevalence rates or clinical effects of informal coercion. RESULTS: Twenty-one publications out of a total of 162 articles met the inclusion criteria. Most publications focused on leverage and inducements rather than persuasion and threat. Prevalence rates of informal coercion were 29–59%, comparable on different study sites and in different settings. The majority of mental health professionals as well as one-third to two-third of the psychiatric patients had positive attitudes, even if there was personal experience of informal coercion. We found no study evaluating the clinical effect of informal coercion in an experimental study design. DISCUSSION: Cultural and ethical aspects are associated with the attitudes and prevalence rates. The clinical effect of informal coercion remains unclear and further studies are needed to evaluate these interventions and the effect on therapeutic relationship and clinical outcome. It can be hypothesized that informal coercion may lead to better adherence and clinical outcome but also to strains in the therapeutic relationship. It is recommendable to establish structured education about informal coercion and sensitize mental health professionals for its potential for adverse effects in clinical routine practice.
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spelling pubmed-51495202016-12-23 Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review Hotzy, Florian Jaeger, Matthias Front Psychiatry Psychiatry INTRODUCTION: Although informal coercion is frequently applied in psychiatry, its use is discussed controversially. This systematic review aimed to summarize literature on attitudes toward informal coercion, its prevalence, and clinical effects. METHODS: A systematic search of PubMed, Embase, PsycINF, and Google Scholar was conducted. Publications were included if they reported original data describing patients’ and clinicians’ attitudes toward and prevalence rates or clinical effects of informal coercion. RESULTS: Twenty-one publications out of a total of 162 articles met the inclusion criteria. Most publications focused on leverage and inducements rather than persuasion and threat. Prevalence rates of informal coercion were 29–59%, comparable on different study sites and in different settings. The majority of mental health professionals as well as one-third to two-third of the psychiatric patients had positive attitudes, even if there was personal experience of informal coercion. We found no study evaluating the clinical effect of informal coercion in an experimental study design. DISCUSSION: Cultural and ethical aspects are associated with the attitudes and prevalence rates. The clinical effect of informal coercion remains unclear and further studies are needed to evaluate these interventions and the effect on therapeutic relationship and clinical outcome. It can be hypothesized that informal coercion may lead to better adherence and clinical outcome but also to strains in the therapeutic relationship. It is recommendable to establish structured education about informal coercion and sensitize mental health professionals for its potential for adverse effects in clinical routine practice. Frontiers Media S.A. 2016-12-12 /pmc/articles/PMC5149520/ /pubmed/28018248 http://dx.doi.org/10.3389/fpsyt.2016.00197 Text en Copyright © 2016 Hotzy and Jaeger. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Hotzy, Florian
Jaeger, Matthias
Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review
title Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review
title_full Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review
title_fullStr Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review
title_full_unstemmed Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review
title_short Clinical Relevance of Informal Coercion in Psychiatric Treatment—A Systematic Review
title_sort clinical relevance of informal coercion in psychiatric treatment—a systematic review
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149520/
https://www.ncbi.nlm.nih.gov/pubmed/28018248
http://dx.doi.org/10.3389/fpsyt.2016.00197
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