Frequency of Physical Restraint and Its Associations With Demographic and Clinical Characteristics in a Chinese Psychiatric Institution

Authors

  • Xiao-Min Zhu MD,

    PhD student
    1. Mental Health Institute of the Second Xiangya Hospital, Central South University, Hunan & Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
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  • Yu-Tao Xiang MD, PhD,

    Attending Psychiatrist, Research Assistant Professor
    1. Beijing Anding Hospital, Capital Medical University, Beijing, China
    2. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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  • Jian-Song Zhou MD, PhD,

    Attending Psychiatrist
    1. Mental Health Institute of the Second Xiangya Hospital, Central South University, Hunan & Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
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  • Lei Gou MD,

    Resident Psychiatrist
    1. Mental Health Institute of the Second Xiangya Hospital, Central South University, Hunan & Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
    2. Tianjin Anding Hospital, Tianjin, China
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  • Seth Himelhoch MD, MPH,

    Associate Professor
    1. Division of Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
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  • Gabor S. Ungvari MD, PhD,

    Professor
    1. School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
    2. The University of Notre Dame Australia/Marian Centre, Perth, Australia
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  • Helen F. K. Chiu FRCPsych,

    Professor
    1. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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  • Kelly Y. C. Lai MRCPsych,

    Associate Professor
    1. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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  • Xiao-Ping Wang MD, PhD

    Professor, Corresponding author
    1. Mental Health Institute of the Second Xiangya Hospital, Central South University, Hunan & Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, Hunan, China
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  • Conflict of Interest Statement

    The authors report no actual or potential conflicts of interest.

Abstract

Purpose

Physical restraint (PR) is a highly controversal topic in psychiatry. Little is known about PR among psychiatric inpatients in China. This study examined the frequency of PR and its relationships with demographic and clinical characteristics among a large psychiatric institution in the Hunan Province, China.

Design and Methods

The study included a consecutively assessed sample of 160 psychiatric inpatients. Sociodemographic and clinical data including use of PR were collected from the medical records using a form designed for this study and confirmed via interview.

Findings

The frequency of PR was 51.3% in the whole sample; 63.2% among female and 39.2% among male patients. In multiple logistic regression analysis PR was independently associated with male gender (p = 0.001, odds ratio [OR] = 0.2, 95% confidence interval [CI] 0.1–0.6), less outpatient treatment prior to admission (p = 0.03, OR = 0.3, 95% CI 0.1–0.9), more frequent use of mood stabilizers (p = 0.002, OR = 5.6, 95% CI 1.9–16.7), more aggressive behavior prior to admission (p = 0.002, OR = 1.1, 95% CI 1.04–1.2), and younger age (p = 0.04, OR = 0.97, 95% CI 0.93–0.99).

Practice Implications

PR is very common in clinical practice in China. Its demographic and clinical correlates are similar to findings in Western settings.

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