[End of a psychiatric era? : Impact on the use of mechanical restraints after prohibition of psychiatric cage beds in a regional psychiatric department in Vienna, Austria]. / Ende einer Ära? : Auswirkungen des Verzichts auf den Einsatz psychiatrischer Intensivbetten in einer psychiatrischen Regionalabteilung Wiens ­ Erste Ergebnisse.

BACKGROUND: Since June 1st, 2014 the use of cage beds, a physical coercive measure in psychiatric wards, is forbidden by Austrian law. The 3rd Psychiatric Department at the Otto Wagner Hospital in Vienna carried out a pilot-study prior to the application of this law and compared 6 months with and 6 months without the use of cage beds in psychiatric acute treatment. The investigation focused on the use of mechanical restraints, especially of 4-point-restraints at admission time. METHODS: The study collected clinical and epidemiological data from the patients and analyzed interviews taken with patients and staff-members after the use of coercive measures. RESULTS: The prohibition of cage beds was associated with a relative increase of the use of 4-point-restraints. Time spent in 4-point-restraints is less than time spent in the cage beds. A trend could also be observed by a decrease of time spent in 4-point-restraints. Data from the interviews showed that there was no preference by patients of either kind of physical restraint. They strongly urged for more personal talks and non-physical and non-pharmacological therapies during admission. CONCLUSIONS: Team members required more human resources for the treatment of these acute psychiatric patients.

[Does mobbing cause posttraumatic stress disorder? Impact of coping and personality]. / Führt Mobbing zur posttraumatischen Belastungsstörung? Implikationen von Stressverarbeitung und Persönlichkeit.

INTRODUCTION: Previous research has documented that a variety of anxiety, depressive, and psychosomatic symptoms are present in a substantial portion of mobbing victims. This study aimed to explore the frequency of posttraumatic stress disorder (PTSD) among mobbing victims, and to investigate how PTSD was linked to pertinent psychometric scales. METHOD: We recruited 20 mobbing victims and conducted the Structural Clinical Interview (SCID) to assess PTSD according to DSM-IV criteria. The trauma criterion was homogeneously defined as mobbing. RESULTS: 55% of our entire sample had a current PTSD, and 70% suffered from severe posttraumatic stress symptoms according to the Impact of Event Scale. Using multivariate analysis of variance (MANOVA), we found that mobbing victims with a current PTSD tended to demonstrate higher levels of stress and depressive symptoms, and less quality of life (SF 36 Short-Form Health Survey), especially in terms of bodily pain, compared with those without a PTSD diagnosis. No significant differences in personality factors (Freiburg Personality Inventory) between mobbing-victims with and without PTSD were evident by multivariate analysis. Univariate statistics, however, revealed that mobbing-related PTSD showed a trend towards higher scores in social orientation and somatic complaints. There was no general evidence that mobbing victims with a PTSD used more often negative and positive coping strategies (SVF - Stress Coping Questionnaire). However, they showed a tendency to employ control strategies, avoidance, social withdrawal, and cognitive preoccupation. CONCLUSION: Posttraumatic stress disorder subsequent to mobbing can occur frequently. PTSD therefore should be specifically considered in routine care.