Improvement of legal institutions of hospitalization of mentally disabled patients / 中国卫生政策研究

The institution of voluntary hospitalization should be improved by establishing the concept of prece-dent autonomy and surrogate decision-making. The institution of advance directives should also be established to pro-tect rights of autonomy for mentally disabled patients. The decision by the guardian provided by China’s Mental Health Law is one situation of surrogate decision-making rather than involuntary hospitalization. The provision of in-voluntary hospitalization, especially“damage”,“safety”, and“danger”, should be properly interpreted on the basis of balancing patient autonomy and social security. Serious mental disorders shall return to the essence of pure medical problems, and the determination of decision-making capacity should be a separate question. Unified criteria for the judgment of decision-making capacity should be established.

Comparative Analysis of Involuntary Admission and Voluntary Admission in Schizophrenia: A 3-Year Follow Up / 신경정신의학

OBJECTIVES : The purpose of this study was to investigate differences between involuntarily and voluntarily hospitalized patients with schizophrenia. METHODS : Patients who were hospitalized between 2001 and 2005 with a diagnosis of DSM-IV schizophrenia were included. The subjects were grouped by whether their admission was voluntary or involuntary. The data were collected through inpatient medical records. The two groups were compared regarding demographic variables and clinical features, and we examined the number of rehospitalizations, duration of follow-up, follow-up retention rate and second admission pattern for a period of 3 years after discharge. RESULTS : 181 subjects were classified as according to their admission into the involuntary group, and 69 subjects as the voluntary group. There were more female patients, more past admissions and longer duration of illness in the involuntary group. The patients in the involuntary group had more problematic behaviors with their chief complaint being delusions. The follow-up retention rate was lower (44.8% vs. 59.4%) and the rate of the second involuntary admission was higher in the involuntary group. CONCLUSION : Involuntary hospitalization may be an important predictor for treatment maintenance in patients with schizophrenia.

Comparative Analysis of Involuntary Admission and Voluntary Admission in Schizophrenia: A 3-Year Follow Up / 신경정신의학

OBJECTIVES : The purpose of this study was to investigate differences between involuntarily and voluntarily hospitalized patients with schizophrenia. METHODS : Patients who were hospitalized between 2001 and 2005 with a diagnosis of DSM-IV schizophrenia were included. The subjects were grouped by whether their admission was voluntary or involuntary. The data were collected through inpatient medical records. The two groups were compared regarding demographic variables and clinical features, and we examined the number of rehospitalizations, duration of follow-up, follow-up retention rate and second admission pattern for a period of 3 years after discharge. RESULTS : 181 subjects were classified as according to their admission into the involuntary group, and 69 subjects as the voluntary group. There were more female patients, more past admissions and longer duration of illness in the involuntary group. The patients in the involuntary group had more problematic behaviors with their chief complaint being delusions. The follow-up retention rate was lower (44.8% vs. 59.4%) and the rate of the second involuntary admission was higher in the involuntary group. CONCLUSION : Involuntary hospitalization may be an important predictor for treatment maintenance in patients with schizophrenia.