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BioMed Research International
Volume 2014 (2014), Article ID 928740, 7 pages
Research Article

Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers

1Department of Legal and Forensic Medicine, Faculty of Medicine, University of Córdoba, Avenida Menéndez Pidal s/n, 14071 Córdoba, Spain
2Medical Services, Secure Psychiatric Hospital of Alicante, Spain
3Medical Services, Prison of Málaga, Spain
4Medical Services, Prison of Córdoba, Spain
5Medical Services, Prison of Granada, Spain
6Medical Services, Secure Psychiatric Hospital of Sevilla, Spain
7Department of Biostatistics, University of Granada, Spain
8Center of Biomedical Research Network of Mental Health (CIBERSAM), University of Granada, Spain

Received 4 April 2013; Accepted 29 October 2013; Published 20 January 2014

Academic Editor: Nick Kontodimopoulos

Copyright © 2014 E. Girela et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.