Validation of psychiatric patients' statements on coercive measures

Objective: To investigate the accuracy of psychiatric patients' statements on coercive measures compared with medical file information using empirical methodology, and relating the statements to patients' psychopathology. Method: One hundred and forty-three in-patients were identified consecutive ly, and interviewed using a structured questionnaire. Psychopathology was m easured using BPRS, and social functioning using GAF. Patients' statements about coercion were compared with information in the medical files. Results: In general, patients stated to have been subjected to more coercio n than was evident from the files. In particular, statements about forced m edication, earlier involuntary commitments and present legal status showed low accordance with information in the files. Low accordance was related to the severity of psychopathology and being schizophrenic. Conclusion: The existence of a 'grey zone' between patients' and doctors' p erception of coercion was confirmed. Knowledge of patients' psychopathology seems essential when considering medical, legal and ethical aspects of the use of coercion.