Factors associated with the use and longer duration of seclusion and restraint in psychiatric inpatient settings: a retrospective chart review

Abstract

Objectives: To examine factors that may affect the use and duration of seclusion and restraint (SR) in psychiatric inpatient settings.Methods: First, multivariable logistic regression analysis was used to examine factors associated with the use of SR in an unmatched case-control study, comparing SR cases and controls. Second, for patients that underwent SR, multivariable linear regression analysis was used to determine factors contributing to the duration of SR.Results: Out of 213 patients, 58 underwent SR. An F00 diagnosis, a history of epilepsy, antipsychotics usage and antidepressants usage were significantly associated with the use of SR (odds ratio = 7.98; 95% CI = 1.11–57.50, odds ratio = 4.89; 95% CI = 1.12–21.36, odds ratio = 4.59; 95% CI = 1.54–13.68 and odds ratio = 0.29; 95% CI = 0.10–0.86, respectively). An F00 and F32 diagnosis significantly extended the duration of SR (coefficient = 13.10; 95% CI = 2.11–24.11 and coefficient = 20.52; 95% CI = 9.68–31.37, respectively).Conclusions: A variety of factors are associated with the use and longer duration of SR. Given the potentially harmful effects of these practices, further studies with larger samples and a wider range of quantitative outcome measures are warranted.Key pointsAn F00 diagnosis, a history of epilepsy and antipsychotics usage may increase the use of SR.Antidepressants may decrease the use of SR.An F00 and F32 diagnosis may extend the duration of SR.