Universität zu Köln

Peters, Sonke Johann ORCID: 0000-0002-1993-6613, Schmitz-Buhl, Mario ORCID: 0000-0001-8403-6972, Karasch, Olaf, Zielasek, Juergen and Gouzoulis-Mayfrank, Euphrosyne (2022). Determinants of compulsory hospitalisation at admission and in the course of inpatient treatment in people with mental disorders-a retrospective analysis of health records of the four psychiatric hospitals of the city of Cologne. BMC Psychiatry, 22 (1). LONDON: BMC. ISSN 1471-244X

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Abstract

Background We aimed to identify differences in predictors of involuntary psychiatric hospitalisation depending on whether the inpatient stay was involuntary right from the beginning since admission or changed from voluntary to involuntary in the course of in-patient treatment. Methods We conducted an analysis of 1,773 mental health records of all cases treated under the Mental Health Act in the city of Cologne in the year 2011. 79.4% cases were admitted involuntarily and 20.6% were initially admitted on their own will and were detained later during the course of in-patient stay. We compared the clinical, sociodemographic, socioeconomic and environmental socioeconomic data (ESED) of the two groups. Finally, we employed two different machine learning decision-tree algorithms, Chi-squared Automatic Interaction Detection (CHAID) and Random Forest. Results Most of the investigated variables did not differ and those with significant differences showed consistently low effect sizes. In the CHAID analysis, the first node split was determined by the hospital the patient was treated at. The diagnosis of a psychotic disorder, an affective disorder, age, and previous outpatient treatment as well as the purchasing power per 100 inhabitants in the living area of the patients also played a role in the model. In the Random Forest, age and the treating hospital had the highest impact on the accuracy and decrease in Gini of the model. However, both models achieved a poor balanced accuracy. Overall, the decision-tree analyses did not yield a solid, causally interpretable prediction model. Conclusion Cases with detention at admission and cases with detention in the course of in-patient treatment were largely similar in respect to the investigated variables. Our findings give no indication for possible differential preventive measures against coercion for the two subgroups. There is no need or rationale to differentiate the two subgroups in future studies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Peters, Sonke Johann UNSPECIFIED orcid.org/0000-0002-1993-6613 UNSPECIFIED Schmitz-Buhl, Mario UNSPECIFIED orcid.org/0000-0001-8403-6972 UNSPECIFIED Karasch, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED Zielasek, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Gouzoulis-Mayfrank, Euphrosyne UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-672353
DOI:	10.1186/s12888-022-04107-7
Journal or Publication Title:	BMC Psychiatry
Volume:	22
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-244X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVOLUNTARY ADMISSIONS; DUAL DIAGNOSIS; CLINICAL CHARACTERISTICS; PERSONALITY-DISORDER; FOLLOW-UP; IMPACT; PREDICTORS; VOLUNTARY; SCHIZOPHRENIA; ASSOCIATIONS Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67235