The relationship between physical restraint and the diagnosis and drug use in the patients receiving inpatient treatment in a child and adolescent psychiatry clinic

Objective: The aim of this study is to evaluate the characteristics such as the diagnosis and medication of the physically restrained patients in our inpatient unit, which is one of the few inpatient units for children and adolescents in Turkey, and the effect of the physical restraint on the treatment of them. Methods: The medical records of 102 inpatients treated in our mental health hospital during the year 2016 had been retrospectively reviewed. Patients who were restrained at least once during the hospitalization period were compared with patients who were not, in terms of diagnosis, medication, presence of comorbidity, duration of hospitalization and the way of discharge. Results: Comparing the groups that were restrained and not restrained, it was found that multiple drug use was more common in the restrained group. The use of antipsychotics, anxiolytics and mood stabilizer drugs and haloperidol-biperiden injections were found to be significantly higher in the restrained group. The rate of multiple psychiatric diagnoses was significantly higher and major depression, conduct disorder, bipolar disorder and self-injurious behaviors were more frequent in the restrained group. Although the duration of hospitalization for both groups was similar, discharge with the request of the family or caregivers before the end of treatment was more frequent in the restrained group. Clinical global improvement scores were lower in the restrained group. Discussion: There are many differences in terms of diagnosis, medication and the way of discharge between the restrained and non-restrained groups. More strategies are needed to reduce the restriction rates.