Pathologische Kreatinkinasewerte (CK) und Zwangsmaßnahmen in der Akutpsychiatrie

Zusammenfassung

Ziel der Studie war, die Assoziation von Zwangsmaßnahmen, erhoben mit der Staff Observation Aggression Scale (SOAS-R) als Folge von Aggressivität mit pathologischen Kreatinkinasewerten (CK-Werten) bei 317 akutpsychiatrischen Patienten zu untersuchen. In einer CHAID-Analyse war ein pathologischer CK-Wert assoziiert mit der Durchführung von Zwangsmaßnahmen; covariierende Variablen waren „Aggressionsanamnese“ und „Hauptdiagnose“. In der ROC-Analyse zeigte sich für pathologische CK-Werte bezüglich späterer Durchführung von Zwangsmaßnahmen eine Sensitivität von 73,5 % und eine Spezifität von 67,5 %.

Abstract

The aim of this study was to investigate the association of compulsory measures (CM) with pathological Creatine Kinase (CK) levels in 317 patients admitted to a secure psychiatric ward. The assumptions is that CK-activity is increased prior to administration of CM because increases in CK-levels may represent aggressive behaviour as precursors of a higher chance of administrating CM. The CK-levels were assessed immediately following admission. During the course of the patients’ stay the frequency of different CM was assessed by the use of the Staff Observation Aggression Scale. In a CHAID analysis pathological CK-levels were associated with subsequent administration of CM. Lifetime aggression and main diagnosis were associated with administration of CM as well. In a ROC analysis concerning pathological CK-activity the AUC for subsequent administration of CM was 70.5 % with a sensitivity of 73.5 % and a specifity of 67.5 %. Despite some methodological shortcomings the study indicates that it could be useful to measure CK-activity at the time of admission because pathological levels may indicate an increased probability of administration of CM subsequent to aggressive behaviour.

Schlüsselwörter

Kreatinkinaseaktivität - Agitiertheit - Aggression - Zwangsmaßnahmen - Prädiktion

Keywords

creatine kinase activity - agitation - aggression - compulsory measures - prediction

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