Ethical conflicts in involuntary treatment of patients with schizophrenia.Decision-making and control of variables in three case reports

Three case reports of patients with schizophrenia were presented to a sampl e of 520 persons (25.1% psychiatrists, 3.7% psychologists, 8.1% social work ers, 14.6% nurses, and 48.6% others). The decisions for involuntary admissi on to a psychiatric hospital and involuntary treatment were questioned. In case 1 (young man,first episode, delusions, extreme social withdrawal), 71. 7% supported admission to hospital and 62.7% were in favor of neuroleptic t reatment. In case 2 (woman with disorganized syndrome beating her 74-year-o ld mother), 84.6% supported hospitalization and 78.8% neuroleptics. In case 3 (relapsed multi-episode patient, increasingly neglected, delusional, and socially withdrawn), 56.3% supported hospitalization and 52.7% neuroleptic s. Generally, psychiatrists' decisions were very similar to those of other professionals and laypersons, while social workers more often rejected invo luntary treatment. After professional status, multivariate analyses reveale d older age as the most significant variable for support of involuntary tre atment. Frequency of experience with mentally ill persons were only weak pr edictors or not significant.