A controlled comparison of involuntarily hospitalized medication refusers and
S. Levin, J. S. Brekke and P. Thomas,
Bull. Amer. Acad. Psychiatry & the Law
19(2): 161-71, 1991.
Involuntarily hospitalized psychiatric patients consecutively admitted over a six-month period who
successfully refused medication (n = 37) are compared with a randomly selected group of
medication-accepting patients committed during the same time period (n = 37). The overall refusal
rate was 15.6 percent during the study period. Acceptors and refusers did not differ on age, sex,
diagnosis, ethnicity, marital status, or preadmission living status. Differences between the groups
indicate that refusers are sicker and lower functioning, are more behaviorally acute on the ward, and
stay in the hospital twice as long as acceptors. Refusers also have a significantly negative impact on
the overall ward milieu. The impact of institutional factors on the rate and outcome from mediation
refusal are discussed.