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The Use of Seclusion Room in a Milieu Therapeutic Psychiatric Ward

This study was designed to investigate the contemporary use of seclusion in psychiatric inpatients. All of the secluded patients who had been admitted to the department of psychiatry of Wonju Christian Hospital, Yonsei University Wonju Medical College, from January 7th until July 7th in 1989，were included in this study. Filling up the check-list and bed side interviews were done at the time of seclusion with regard to some aspects of the use of seclusion. Comparison between secluded and non-secluded revealed below ; 1) Seclusion was used at some point during hospitalization once or more in 61 patients(36. 6% ) among 167 patients. 2) The number of times that seclusion was used ranged from 1 to 11 (mean 3.79±7.32, P <0.05). 3) By age distribution, more seclusion was used in younger age group (P<C0.05). 4) By marital status, singles (6 7 .2 0 were secluded more frequently than the married (32.8 % )(P<0.05). 5) With regard to admission mode, patients with compulsory admission(80.3% ) were secluded more frequently than the voluntary ones(19.7% ) (P< 0.05). 6) The duration of hospital stay of secluded group were 55 ±34.14 and was significantly longer in the secluded group than non-secluded group(30± 27.8) (P < 0.05). 7) Both manic (34.4 ^ ) and schizophrenic (23.0 %) patients were found more in the secluded group than non-secluded group(P〈0.01，P<0.05 respectively). Comparison between psychotics and non-psychotics revealed below ; 1) Other staffs(82.3%) predicted seclusion more readily than doctors did (P 〈0.05). 2) Seclusion was administered more frequently during night time in psychotic groups, compared to non-psychotic groups(P<C0.05). 3) The most com m on reason for seclusion was ‘behavior disruptive to the therapeutic environment( 45.2 %) ’. The rest of the reasons were ‘uncontrolled symptom (38.4 % ) 1 ‘violent behavior (23, 25.0%)9 in psychotics. In non-psychotics, behavior treatment(16.7%) was the most frequent cause (P〈0.05). 4) In psychotic group, duration of seclusion revealed more than 24 hours 32.3%, and in and 4 &#8212;12 hours in 25.0%. 5) For other treatment modalities, use of medications (46.4 %) and use of physical restraint (22.0%) were frequently done in psychotics, but in non-psychotics, simple isolation (32.4 %) and interview(3 2 .4 0 were com m on(P〈0.05)