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Title: Socio-Demographic and Clinical Characteristics of Adults With Psychotic Symptomatology Under Involuntary Admission and Readmission for Compulsory Treatment in a Referral Psychiatric Hospital in Cyprus
Authors: Kaikoushi, Katerina 
Middleton, Nicos 
Chatzittofis, Andeas 
Bella, Evanthia 
Alevizopoulos, Giorgos 
Karanikola, Maria 
Major Field of Science: Medical and Health Sciences
Field Category: Clinical Medicine
Keywords: Cyprus;Coercion;Compulsory treatment;Demographic;Involuntary;Non-adherence;Psychosis;Readmission
Issue Date: 17-Feb-2021
Source: Frontiers in Psychiatry, 2021, vol. 12, articl. no. 602274
Volume: 12
Journal: Frontiers in Psychiatry 
Abstract: Socio-demographic and clinical characteristics of adults under compulsory psychiatric treatment, have not been reported adequately in Southern European countries. We investigated the socio-demographic and clinical characteristics of adults with psychotic symptomatology who were involuntarily treated in the acute Mental Health Services in Cyprus. A descriptive cross-sectional study was applied. Data collection (December 2016 to February 2018) achieved via a structured questionnaire including demographic and clinical variables. Census sampling was applied in Cyprus referral center for compulsory psychiatric treatment. The sample included 406 individuals (262 males, 144 females). Approximately 86.2% were single, 77.6% were unemployed, and 24.9% held a bachelor's degree. The most frequent clinical diagnosis was schizophrenia or a relevant psychotic disorder (86.4%). The most frequent admission cause was non-adherence to pharmacotherapy along with disorganized behavior (agitation and/or self-care deficit, and/or aggressive behavior, and/or suicidal behavior) (53.6%). Moreover, 70.7% of the sample reported a positive personal history of mental health problems, while 42.1% reported a positive family history of mental health disorders. Half of the participants (52%) were previously involuntarily admitted for compulsory treatment. Adjusted associations of readmission status were reported with Cypriot ethnicity (OR: 4.40, 95%CI: 2.58-7.50), primary education only (OR: 3.70, 95%CI: 1.64-8.37), readmission due to disorganized behavior along with non-adherence to pharmacotherapy (OR: 10.84, 95%CI: 2.69-43.72), as well as along with substance use (OR: 6.39, 95%CI: 1.52-26.82). Readmission was almost five times more likely to occur due to suicidal behavior (OR: 5.01, 95%CI: 1.09-22.99) compared to disorganized behavior not otherwise specified. Additionally, those with a diagnosis of schizophrenia were more than 12 times more frequently readmitted for compulsory treatment compared to other diagnoses (OR 12.15, 95%CI: 1.04-142). Moreover, the participants with higher secondary education had 54.6% less odds to be involuntarily re-admitted compared to Bachelor degree holders (OR 0.442, 95%CI: 0.24-0.79). A high percentage of involuntary treatment was noted due to non-adherence to pharmacotherapy and substance use. Re-evaluation of the effectiveness of relevant community interventions is suggested, as well as implementation of structured educational programs on therapy adherence during psychiatric hospitalization.
ISSN: 1664-0640
DOI: 10.3389/fpsyt.2021.602274
Rights: This is an open-access article distributed under the terms of the Creative Commons Attribution License
Attribution-NonCommercial-NoDerivatives 4.0 International
Type: Article
Affiliation : Cyprus Ministry of Health 
Cyprus University of Technology 
University of Cyprus 
National and Kapodistrian University of Athens 
Appears in Collections:Άρθρα/Articles

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