Difference between forensic patients with schizophrenia spectrum disorders in Italy and other European countries: Results of the EU-VIORMED project

IF 1.1 4区 医学 Q3 CRIMINOLOGY & PENOLOGY Criminal Behaviour and Mental Health Pub Date : 2023-07-18 DOI:10.1002/cbm.2302
Luca Castelletti, Laura Iozzino, Manuel Zamparini, Janusz Heitzman, Inga Markiewicz, Giuseppe Nicolò, Marco Picchioni, Giuseppe Restuccia, Gianfranco Rivellini, Fabio Teti, Johannes Wancata, Giovanni de Girolamo
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Abstract

Background

There has been a substantial change in the law on the provision of secure health services for offender-patients in Italy, a country currently with the lowest general psychiatry bed availability per head of the population in Europe, raising questions about possible differences in offender-patient admissions between European countries.

Aims

In this multicentre case–control study, our aim was to compare the socio-demographic, clinical and criminological characteristics of a sample of Italian forensic in-patients with schizophrenia or similar psychosis with patients in a similar diagnostic range in specialist in-patient services elsewhere in Europe.

Methods

Secure hospital unit in-patients with psychosis were recruited across five European countries (Italy, Austria, Germany, Poland and England). Consenting patients were interviewed by researchers and assessed using a multidimensional standardised process. Within country similarities between Austria, Germany, Poland and England were confirmed.

Results

Overall, 39 Italian participants had had fewer years of education than the 182 patients in the other countries and were less likely to have ever had skilled or professional employment. The Italian patients had been older at first contact with any mental health services than the other Europeans. Diagnosed comorbidity rates were similar, but the Italian group reported higher levels of disability. Although the other European forensic patients were more likely to be undergoing treatment at the time of their index offence, they were also more likely to have been poorly compliant with treatment. The rate of suicide-related behaviours was significantly lower among the Italian patients than among the others.

Conclusions

Notwithstanding similar diagnoses, important differences emerged between patients in Italian forensic mental health resident services and those in four other European countries, some possibly reflecting less access to earlier relevant services in Italy. Others, including lower disability ratings among the Italian patients and a lower rate of suicide-related behaviours, may indicate that the Italian reforms carry benefits. This is worthy of further evaluation.

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意大利和其他欧洲国家精神分裂症谱系障碍法医患者的差异:欧盟- viormed项目的结果
背景意大利在为罪犯患者提供安全保健服务方面的法律有了重大变化,意大利目前是欧洲人均普通精神病学床位利用率最低的国家,这引发了欧洲各国在罪犯患者入院方面可能存在差异的问题。在这项多中心病例对照研究中,我们的目的是比较意大利精神分裂症或类似精神病的法医住院患者样本与欧洲其他地方专科住院服务中诊断范围相似的患者的社会人口学、临床和犯罪学特征。方法在5个欧洲国家(意大利、奥地利、德国、波兰和英国)招募住院精神病患者。研究人员对同意的患者进行了访谈,并使用多维标准化过程进行了评估。在国家内部,奥地利、德国、波兰和英国的相似性得到了证实。结果:总体而言,39名意大利参与者的受教育年限比其他国家的182名患者要少,并且不太可能有过技术或专业工作。意大利患者第一次接触精神卫生服务的年龄比其他欧洲人要大。诊断出的合并症发生率相似,但意大利组报告的残疾水平更高。尽管其他欧洲法医病人在他们的主要罪行发生时更有可能正在接受治疗,但他们也更有可能对治疗依从性差。意大利患者的自杀相关行为率明显低于其他患者。结论:尽管诊断相似,但意大利法医精神卫生住院服务的患者与其他四个欧洲国家的患者之间出现了重大差异,其中一些可能反映了意大利较早获得相关服务的机会较少。其他方面,包括意大利患者中较低的残疾评级和较低的自杀相关行为率,可能表明意大利的改革带来了好处。这一点值得进一步评价。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
40
期刊介绍: Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.
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