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The EUNOMIA study design: definitions and implementation in 13 European centers


Previous (mostly national) research has shown significant variation of different aspects of coercive treatment measures. Therefore, clinical practice and outcome of these measures should be assessed at an international level facilitating cross-national comparisons.


This was the general research objective of the EC-funded EUNOMIA-project. Using a standardized battery of instruments (e.g. covering psychopathology, perceived coercion, satisfaction with treatment, quality of life) each center assessed two groups of general adult psychiatric patients for a three-month follow-up period (time-points of assessments: within the first week after hospital admission, 4 weeks and 3 months after hospital admission): legally involuntarily admitted patients (aimed at figure of complete cases in each center: N = 140) and legally voluntarily admitted patients who – according to a screening procedure – felt coerced to admission (aimed at figure in each center: N = 40). Further, and by use of a standardized instrument all individual coercive measures applied to the clientele within the first 4 weeks of the index-treatment were recorded, in detail: mechanical restraint, seclusion, forced medication, and detention after voluntary admission.


The naturalistic and epidemiologically oriented study design was successfully implemented in 13 catchment areas in 12 European countries; data collection – having lasted at least 24 months – ended in June 2006, and data correction was finalized in November 2006. The project's final database comprises individual datasets of 2,586 legally involuntarily admitted patients, and of 830 legally voluntarily admitted patients who felt coerced to admission.


Results are embedded in standardized information on the organization of mental health care inthe participating catchment areas which was collected by use of the instruments developed by the European Psychiatric Care Assessment Team.

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Correspondence to Thomas Kallert.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Kallert, T. The EUNOMIA study design: definitions and implementation in 13 European centers. BMC Psychiatry 7, S96 (2007).

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  • Catchment Area
  • Mental Health Care
  • European Center
  • Complete Case
  • Screen Procedure