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Tijdschrift voor Psychiatrie 42 (2000) 6, 381 - 387

New research

Assessment of dangerousness and best interest

P.J.A. van Panhuis, P.M.A.J. Dingemans

background Compulsory admission in a psychiatric hospital is since 1970 in the Netherlands in acute conditions only possible when there exists dangerousness for the person himself or his surroundings. Since 1982 also in not acute situations the 'best interest' of the patient is not any longer a reason for compulsory admission.
aims This research explored the question of whether dangerousness for oneself and/or the environment, and 'best interest' can be readily distinguished in clinical reality.
method Two random samples of 60 cases each from the Amsterdam Crisiscenter database on compulsory psychiatric admissions were drawn; one from the year 1970 and one from the year 1985. The cases were introduced to a panel of six psychiatrists. They were asked to rate with regard to separate presence of dangerousness of the patient for himself and/or his environment, and the presence of the patient's best interest in combination of both best interest and dangerousness.
results The panel members rated the co-occurrence of dangerousness and best interest as present more often.
conclusions According to the authors this means that both dangerousness to oneself and/or environment, and best interest are inseparable elements of one clinical reality.

keywords best interest, compulsory psychiatric admission, dangerousness