Coerced Hospital Admission and Symptom Change—A Prospective Observational Multi-Centre Study Kallert, Thomas W. Katsakou, Christina Adamowski, Tomasz Dembinskas, Algirdas Fiorillo, Andrea Kjellin, Lars Mastrogianni, Anastasia Nawka, Pětr Onchev, Georgi Raboch, Jiri Schützwohl, Matthias Solomon, Zahava Torres González, Francisco Bremner, Stephen Priebe, Stefan Diagnostic medicine Employment Hospitals Law and legal sciences Legislation Medical ethics Psychometrics Schizophrenia [Introduction] Coerced admission to psychiatric hospitals, defined by legal status or patient's subjective experience, is common. Evidence on clinical outcomes however is limited. This study aimed to assess symptom change over a three month period following coerced admission and identify patient characteristics associated with outcomes. [Method] At study sites in 11 European countries consecutive legally involuntary patients and patients with a legally voluntary admission who however felt coerced, were recruited and assessed by independent researchers within the first week after admission. Symptoms were assessed on the Brief Psychiatric Rating Scale. Patients were re-assessed after one and three months. [Results] The total sample consisted of 2326 legally coerced patients and 764 patients with a legally voluntary admission who felt coerced. Symptom levels significantly improved over time. In a multivariable analysis, higher baseline symptoms, being unemployed, living alone, repeated hospitalisation, being legally a voluntary patient but feeling coerced, and being initially less satisfied with treatment were all associated with less symptom improvement after one month and, other than initial treatment satisfaction, also after three months. The diagnostic group was not linked with outcomes. [Discussion] On average patients show significant but limited symptom improvements after coerced hospital admission, possibly reflecting the severity of the underlying illnesses. Social factors, but not the psychiatric diagnosis, appear important predictors of outcomes. Legally voluntary patients who feel coerced may have a poorer prognosis than legally involuntary patients and deserve attention in research and clinical practice. 2014-03-20T09:41:49Z 2014-03-20T09:41:49Z 2011 journal article Kallert, T.W.; et al. Coerced Hospital Admission and Symptom Change—A Prospective Observational Multi-Centre Study. Plos One, 6(11): e28191 (2011). [http://hdl.handle.net/10481/30994] 1932-6203 doi: 10.1371/journal.pone.0028191 http://hdl.handle.net/10481/30994 eng open access Public Library of Science (PLOS)