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Involuntary Admission of Emergency Psychiatric Patients: Report From the Amsterdam Study of Acute Psychiatry

Professor van der Post, Mr. Bernardt, Dr. Schoevers, and Professor Dekker are affiliated with the Research Department, ARKIN Mental Health Care, Overschiestraat 65 1062XD, Amsterdam, Netherlands (e-mail: lvdp{at}xs4all.nl). Professor Mulder is with the Department of Psychiatry, Erasmus Medical Center, University Medical Center, Rotterdam, Netherlands. Professor Beekman is with the Department of Psychiatry, VU University Medical Center (VUMC), Amsterdam, where Dr. Schoevers is also affiliated. Professor Dekker is also with the Faculty of Psychology and Pedagogy, VUMC.

OBJECTIVE: This brief report presents initial data from the Amsterdam Study of Acute Psychiatry (ASAP-I) about factors associated with the decision to admit patients compulsorily (involuntarily) to emergency psychiatric services in the Amsterdam region of the Netherlands. METHODS: The study was a prospective cohort study of 1,970 consecutive patients who came into contact with the Psychiatric Emergency Service Amsterdam. RESULTS: A history of more than 14 outpatient contacts the previous year was associated with a low risk of compulsory admission (OR=.3). An involuntary admission in the previous five years was associated with a higher risk (OR=3.7). Referral by a general practitioner was associated with a low risk compared with referral by police (OR=2.4) or by mental health services (OR=2.3). CONCLUSIONS: The hypothesis that outpatient treatment may help to prevent compulsory admission found some support in this study. More research is needed to understand the mechanisms of the associations so that an intervention study can be developed to test this hypothesis.

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