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Fortschr Neurol Psychiatr. 2019 Oct;87(10):540-547. doi: 10.1055/a-0597-1974. Epub 2018 Dec 11.

[Coercion and aggression in psychiatry: the individual psychological dimension of aggressive and coercive acts by therapists].

[Article in German; Abstract available in German from the publisher]

Author information

Klinik für Psychiatrie und Psychotherapie, Klinikum Lüdenscheid, Märkische Klinken.
Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum.


in English, German

There is a long paternalistic tradition in psychiatry and medicine in general. With a view on that, the law has been changed in order to strengthen patients' autonomy and personal rights and also to reduce coercion and violence. Nowadays, medical and therapeutic actions have to take place within stricter and narrower boundaries and the balance between therapists' provision of care and patients' rights of autonomy had to be renegotiated. In the present paper organisational, structural and legal factors which foster the emergence of coercion and violence in psychiatric treatment will be reported along with factors lying within therapists themselves. Individual factors of therapists that foster the emergence of coercion and violence are amongst other factors suggested by partly tremendous differences in prevalence rates of coercion and violence between hospitals and regions. Aggression coming from therapists can be frequently observed in clinical practice and are also reported in the literature. However, this issue nevertheless is a kind of taboo amongst therapists. Aggression, coercion and violence coming from therapists can be explained by their personality, attitudes, level of training and knowledge and also by their individual biography and involvement in cultures and traditions of clinical teams and hospitals. Despite changes in law the prevalence of coercion and violence in psychiatry is still too high. Amongst other factors, also individual factors of therapists can be made responsible for this situation.

[Indexed for MEDLINE]

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