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Original Articles

Self-reported symptoms and treatment outcome among non-offending involuntary inpatients

Pages 88-106 | Published online: 07 Mar 2011
 

Abstract

The mediating effects of patient legal status on the accuracy of self-reported psychiatric symptoms have not been systematically explored. Problematically, involuntary hospitalization may be associated with a decreased willingness to accurately report symptoms, which may negatively impact choice of treatment intervention and subsequent treatment outcome. The following study examined the association of patient legal status with self-reported psychiatric symptoms and treatment outcome. Self-report data (BDI and SCL-90-R) and clinician-based ratings (BPRS-A) were collected from 131 inpatients during an index period of 8 months. The results showed involuntarily admitted patients endorsed fewer psychiatric symptoms both on the SCL-90-R and on the BDI. This finding was specific to patients with schizophrenia or bipolar disorder, and did not generalize to patients with clinical depression. BPRS-A ratings did not differ between the voluntary and involuntary groups, suggesting an inherent difference among patients with regard to willingness and/or ability to endorse psychiatric symptoms. Involuntarily admitted inpatients also remained hospitalized longer and may have shown poorer treatment outcome. The findings highlight the importance of acknowledging patient legal status when using self-report data to guide assessment and treatment among involuntarily admitted individuals with schizophrenia or bipolar disorder. Potential methods to circumvent this problem are outlined.

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