Characteristics of forensic psychiatric patients with a neurocognitive disorder.

IF 3.9 3区医学 Q1 PSYCHIATRY BJPsych Open Pub Date : 2024-05-20 DOI:10.1192/bjo.2024.712

Jesse Meijers, Niki C Kuin, Erik J A Scherder, Joke M Harte

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Abstract

Background: Emotional and behavioural disturbances accompanying neurocognitive disorders may sometimes lead to a criminal offence. Our knowledge of this specific forensic subpopulation is lagging behind the knowledge on, and attention for, 'classic' psychiatric disorders in forensic populations.

Aims: To gain knowledge on the prevalence and characteristics of individuals with neurocognitive disorders in the forensic population.

Method: This retrospective database study uses an anonymised data-set of the National Database of penitentiary psychiatric centres (PPC) (N = 8391), which collects data on all patients admitted to one of the four PPCs (mental health clinics within the prison system) in The Netherlands since May 2013. Inclusion criterion for this study was the presence of a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) or Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic code belonging to the category of neurocognitive disorders.

Results: A DSM-IV-TR or DSM-5 diagnostic code of a neurocognitive disorder was classified in 254 out of 8391 unique individuals, resulting in a prevalence of 3.0% in the total PPC population. The most prevalent diagnosis was unspecified neurocognitive disorder (59.1%). The neurocognitive disorder group significantly differed from a random control group from the database (n = 762) on demographic, clinical and criminological variables.

Conclusions: The prevalence of neurocognitive disorders in this real-world clinical sample is remarkably lower than in two earlier studies in similar populations. Also remarkable is the relatively high prevalence of an unspecified neurocognitive disorder. These findings lead us to hypothesise that neurocognitive disorders may be underdiagnosed in this population. Forensic psychiatric settings should evaluate whether they have sufficient expertise available in neuropsychological assessment.

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患有神经认知障碍的法医精神病患者的特征。

背景：伴有神经认知障碍的情绪和行为障碍有时可能会导致刑事犯罪。我们对这一特殊法医亚群的了解和关注落后于对法医人群中 "典型 "精神障碍的了解和关注。目的：了解法医人群中神经认知障碍患者的患病率和特征：这项回顾性数据库研究使用了国家监狱精神病治疗中心（PPC）数据库（N = 8391）的匿名数据集，该数据库收集了自 2013 年 5 月以来荷兰四家监狱精神病治疗中心（监狱系统内的精神卫生诊所）之一收治的所有患者的数据。本研究的纳入标准是存在属于神经认知障碍类别的《精神疾病诊断与统计手册》第四版文本修订版（DSM-IV-TR）或《精神疾病诊断与统计手册》第五版（DSM-5）诊断代码：结果：在 8391 名患者中，有 254 人的神经认知障碍诊断代码属于 DSM-IV-TR 或 DSM-5 诊断代码的范畴，因此在整个 PPC 群体中的患病率为 3.0%。最常见的诊断是未指定的神经认知障碍（59.1%）。在人口统计学、临床和犯罪学变量方面，神经认知障碍组与数据库中的随机对照组（n = 762）存在显著差异：结论：在这一真实世界的临床样本中，神经认知障碍的患病率明显低于早先在类似人群中进行的两项研究。同样引人注目的是，未指定神经认知障碍的患病率相对较高。这些发现使我们推测，神经认知障碍在这一人群中可能诊断不足。法医精神病学机构应评估其在神经心理学评估方面是否有足够的专业知识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BJPsych Open Medicine-Psychiatry and Mental Health

CiteScore

6.30

自引率

3.70%

发文量

610

审稿时长

16 weeks

期刊介绍： Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.