Acute psychiatric treatment and the use of physical restraint in first-generation immigrants in Italy: A prospective concurrent study

• Published in: International journal of social psychiatry 2013-09, Vol.59 (6), p.613-618
• Main Authors: Tarsitani, Lorenzo, Pasquini, Massimo, Maraone, Annalisa, Zerella, Maria Paola, Berardelli, Isabella, Giordani, Roberta, Polselli, Gian Marco, Biondi, Massimo
• Format: Article
• Language: English
• Subjects: Adult; Africa - ethnology; Asia - ethnology; Clinical assessment; Cohort Studies; Emigration and Immigration - statistics & numerical data; Europe - ethnology; Female; Hospitalization - statistics & numerical data; Hospitals, Psychiatric - statistics & numerical data; Humans; Immigrants; Intensive care; Intervention; Interventions; Italy; Italy - epidemiology; Latin America - ethnology; Length of Stay - statistics & numerical data; Male; Medical treatment; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - therapy; Mental health care; Mentally ill people; Noncitizens; Patients; Prospective Studies; Psychiatry; Restraint, Physical - statistics & numerical data; Restraints; Risk assessment
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/0020764012450985

Background and Aims: Immigrants in Europe appear at higher risk of psychiatric coercive interventions. No studies have investigated this issue in Italy. The aim of this study is to investigate whether the use of physical restraint, compulsory admission and other treatment characteristics differ in immigrated and Italian-born patients admitted to a psychiatric intensive care unit. Methods: One hundred first-generation immigrant patients were compared to 100 age-, gender- and diagnosis-matched Italian-born patients. Subjects were diagnosed according to DSM-IV-TR and rated on the Clinical Global Impression – Severity Scale and the Global Assessment of Functioning. Clinical data and treatment characteristics were collected. Results: Immigrant patients were more likely to be physically restrained as compared to Italian-born patients (11% vs 3%; χ2 = 4.92; p = 0.027; RR = 3.67; 95% CI = 1.05–12.7). No differences in the proportion of involuntary treatment were found. Immigrant patients did not receive higher doses of antipsychotics or benzodiazepines, but they had a longer stay in the hospital. Conclusions: The higher rate of physical restraint among migrants may reflect cultural, ethnic and language differences leading to communication problems between immigrant patients and mental health professionals. Since coercive interventions can be harmful, specific strategies to prevent this phenomenon in immigrants are needed.