The use of coercive measures in clinical practice represents a common, but understudied problem in Europe. In 2002–2005, the European Commission funded the study “European Evaluation of coercion in psychiatry and harmonization of best clinical practice” (EUNOMIA), coordinated by the Department of Psychiatry of the University of Dresden and carried out in 12 European countries.

This study, carried out on the Italian EUNOMIA sample, aims to:

1. 1) assess the use of coercive measures in five Italian mental health inpatient units;

2. 2) identify the patients’ socio-demographic and clinical characteristics associated with the use of coercive measures;

3. 3) investigate the effect of coercive measures on the outcome of the patients.

The Italian sample included 294 admitted patients. Data were collected on coercive measures (physical restraint, seclusion and forced medication)

Almost 30% of the patients received coercive measures during their hospitalization; in particular, 22% received forced medication, 9% were restrained or fixed by mechanic devices, 7% were seclused. The most frequent reason for prescribing coercive measures was aggression against others. Patients who received coercive measures were more frequently male, with higher BPRS scores and a worse social functioning. At three months after discharge, they showed higher levels of positive symptoms, and reported more negative opinions on the need of hospital admission and on the appropriateness of psychiatric treatments.

In Italy coercive measures are in most of the cases applied to the patients affected by more severe psychopathology and disability.