Clinical characteristics of restrained patients in the Children's Clinical University Hospital Child psychiatry clinic inpatient ward in the years 2013 to 2022.

Objectives. To evaluate the clinical characteristics (age, gender, clinical diagnoses) of the patients that have been subjected to coercive measures (seclusion or restraint) while receiving inpatient psychiatric care in the Clinical University Hospital between 2013 and 2022.
Materials and Methods. A retrospective study was conducted using Children’s Clinical University Hospital inner documentation and data from archives that included clinical patient data, restraint, and seclusion protocols. IBM SPSS v.26 was used for statistical analysis.
Results. The total number of inpatients in the child psychiatry unit who were restrained and secluded between 2013 and 2022 was 79 or 1.6% of all 4819 of inpatients in the child psychiatry unit. 53 (67.1%) of the patients were male. The average age of the patients was 13.1 years (SD = 2.57), the youngest patient being 7 y.o., and the oldest – 17 y.o. The average length of hospital stay of coerced patients was 18.5 (SD = 23.6) hospital days. The average number of instances of seclusion or restraint per patient was 3.0 (SD = 4.38). The majority of patients (63.3%) were coerced only once during their hospital stay, and 27.8% were secluded or restrained 3 and more times. The maximal number of instances of coercion per patient was 30. The most frequent clinical diagnosis groups among restrained patients were intellectual disability (34.2%, N = 27), conduct disorder (31.6%, N = 25), substance use-related disorders (19.0%, N = 15), schizophrenia (12.7%, N = 10) and organic mental disorders (11.4%, N = 9) or a combination of thereof.
Conclusions. The typical patient at risk of requiring coercive measures during inpatient psychiatric treatment is an adolescent boy with a severe neurodevelopmental disorder (e.g. intellectual disability, schizophrenia) or externalizing disorder (e.g. conduct disorder, substance use-related disorder)