Predictors of perceived coercion in patients admitted for psychiatric hospitalization and the stability of these perceptions over time

The origins of patients' perceptions of coercion during short-term psychiatric hospitalization are varied. The purpose of this study was to elucidate the characteristics of patients that are associated with higher levels of perceived coercion and to determine whether these perceptions remain stable one year after admission. One hundred and twenty-five patients were recruited within three days of admission to the acute units at the Alfred Hospital Inpatient Psychiatry Department, Melbourne, Australia. In the initial recruitment phase, patients' perceptions of coercion, psychiatric symptoms and interpersonal style were assessed using the Macarthur Admission Experience Scale, the Brief Psychiatric Rating Scale-18 and the Impact Message Inventory-Circumplex. Admission status (voluntary versus involuntary) and demographic characteristics were also assessed. Follow-up assessments were conducted approximately one year later. Results suggest that a significant but small positive correlation existed between perceived coercion and a Hostile-Dominant interpersonal style at initial recruitment. Females reported significantly higher perceptions of coercion than males, but admission status and severity of psychiatric symptoms were unrelated to perceived coercion. Despite perceptions of coercion appearing to lessen over time, there is a need for specific interventions for these patients during their admission to hospital. There was a statistically significant decrease in perceived coercion over time.