Criminal Behaviour and Mental Health最新文献_第5页

CBMH issue 5, volume 33 highlights CBMH第5期，第33卷集锦。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-10-06 DOI: 10.1002/cbm.2313

Pamela J Taylor

引用次数: 0

Mental health outcomes for those who have offended and have been given a Mental Health Treatment Requirement as part of a Community Order in England and Wales 作为英格兰和威尔士社区令的一部分，那些被冒犯并被给予心理健康治疗要求的人的心理健康结果。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-09-23 DOI: 10.1002/cbm.2312

Matthew Callender, Greta Arancia Sanna, Kathryn Cahalin

Background

Growing evidence of mental disorders among people going through the criminal justice system suggests the potential benefit of courts adding a Mental Health Treatment Requirement (MHTR) when sentencing an offender to a Community Order (sentence) in England and Wales. Although available since 2003, MHTRs have not been widely used, and there is little evidence on outcomes.

Aim

To conduct the first large-scale evaluation of mental health outcomes of people with an MHTR as part of their community sentence across multiple sites in England and Wales.

Methods

Data were collected from 14 sites in England and Wales about individuals who were given an MHTR as part of a community sentence. They were assessed before and after this. During the MHTR, they received a psychotherapeutic intervention by assistant psychologists in a primary care framework. Measures of psychological distress (Clinical Outcomes in Routine Evaluation—Outcome Measure), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire) were completed before the MHTR was implemented and after completion.

Results

Where paired sample t-tests and Wilcoxon signed ranked tests were used, with samples ranging between 309 and 447 individuals, clinically significant changes were obtained for all measures. Most individuals (63%) were identified as experiencing a reliable change in at least two out of the three scales. Finally, a negative linear relationship, between measures at the start of the intervention and reliable change, was identified with higher pre-measures, indicating that more initial distress, anxiety and/or depression were associated with more sizeable changes.

Conclusions

This paper provides the first substantial evidence in support of the MHTR within a primary mental healthcare framework as an effective pathway to reduce mental health problems among individuals under probation supervision as part of a sentence after conviction for a criminal offence. This supports the expansion of the provision across England and Wales. Future research should take account of the non-completers and explore the relationship between the MHTR, mental health improvements and reoffending.

背景：越来越多的证据表明，在英格兰和威尔士，通过刑事司法系统的人中存在精神障碍，这表明法院在对罪犯判处社区令时增加精神健康治疗要求（MHTR）的潜在好处。尽管MHTR自2003年以来一直可用，但尚未得到广泛使用，而且几乎没有关于结果的证据。目的：在英格兰和威尔士的多个地点对作为社区判决一部分的MHTR患者的心理健康结果进行首次大规模评估。在此之前和之后对其进行了评估。在MHTR期间，他们在初级保健框架内接受了助理心理学家的心理治疗干预。在实施MHTR之前和完成之后，完成心理困扰（常规评估结果测量中的临床结果）、焦虑（广泛性焦虑障碍-7）和抑郁（患者健康问卷）的测量。结果：在使用配对样本t检验和Wilcoxon符号排序检验的情况下，样本范围在309至447人之间，所有测量都获得了临床显著变化。大多数个体（63%）在三个量表中至少有两个量表出现了可靠的变化。最后，干预开始时的测量值和可靠的变化之间存在负线性关系，预测量值越高，表明更多的初始痛苦、焦虑和/或抑郁与更大的变化相关。结论：本文提供了第一个实质性证据，支持在初级心理健康框架内实施MHTR，作为减少缓刑监督下个人心理健康问题的有效途径，作为刑事犯罪定罪后判刑的一部分。这支持在英格兰和威尔士扩大这一规定。未来的研究应该考虑到未完成者，并探索MHTR、心理健康改善和再犯之间的关系。

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引用次数: 0

Response to Donnir, G. M., & Asare-Doku, W. (2023). Prevalence of psychiatric disorders among sentenced prisoners in a medium security prison in Ghana: Implications for mental health assessment and service 对Donnir，G.M.和Asare Doku，W.的回应（2023）。加纳一所中等安全级别监狱中被判刑囚犯的精神障碍患病率：对心理健康评估和服务的影响。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-09-11 DOI: 10.1002/cbm.2311

LienChung Wei

引用次数: 0

Psychological screening service for men newly admitted to an Italian prison: Preliminary clinical outcome analysis after 1 year of clinical activity 意大利监狱新收监男子的心理筛查服务：临床活动一年后的初步临床结果分析。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-09-11 DOI: 10.1002/cbm.2310

Lorenzo Pelizza, Enrico Rossi, Ursula Zambelli, Elisa Violante, Melania Scarci, Elena Mammone, Adriana Adriani, Simona Pupo, Giuseppina Paulillo, Pietro Pellegrini

Background

Screening for mental disorders among prisoners is crucial for early detection and intervention of psychopathology and substance use disorders. In Italy, only a minority of prisons have implemented a structured screening process, and there is not yet a standard approach to this worldwide.

Aims

First, to describe a systematic psychological screening for early identification of mental disorder, including drug use disorders, and suicide risk among men on reception into one Italian prison, designed to inform management and, secondly, to describe mental health outcomes among those prisoners accepted into the in-reach mental health service as a result of the assessment.

Methods

All prisoners newly received in the Parma Penitentiary Institute at any time in 2020 were screened using the Jail Screening Assessment Tool. Those who screened positive for any mental disorder, including substance use disorders and suicide indicators, were asked to complete the Parma Scale for the treatment evaluation of offenders with psychiatric disorders (Pr-Scale), a locally developed tool that allows for the measurement of mental state change as well as changes in treatment and management. Scores on this scale soon after reception were compared with scores after 1 year of work with the in-reach team.

Results

Among 303 newly admitted male prisoners in 2020, 167 (55%) screened positive for substance use disorder and 30 (10%) for other primary mental disorders. Most of these (n = 151) were offered and accepted care by the mental health in-reach service. After 1 year, those who had been treated by this service showed significant improvement in all Pr-Scale clinical variables.

Conclusions

Our findings support the extension of a psychological screening into a service for new receptions to Italian prisons. They add evidence for the utility of the Pr-Scale for detecting those newly admitted prisoners likely to benefit from early mental health interventions provided by in-reach services and for evidencing resultant change. Future studies are needed to replicate our results in other Italian prisons as a precursor to systems improvement, while other countries might also benefit from using similar evaluation and reevaluation routinely.

背景：对囚犯进行精神障碍筛查对于早期发现和干预精神病理学和物质使用障碍至关重要。在意大利，只有少数监狱实施了结构化的筛查程序，而全世界还没有一个标准的方法。目的：首先，描述一项系统的心理筛查，以早期识别意大利一所监狱接收的男性的精神障碍，包括药物使用障碍和自杀风险，旨在为管理层提供信息；其次，描述评估结果显示，接受可及精神健康服务的囚犯的心理健康结果。方法：使用监狱筛查评估工具对2020年任何时候新入住帕尔马监狱的所有囚犯进行筛查。那些对任何精神障碍（包括物质使用障碍和自杀指标）筛查呈阳性的人被要求完成帕尔马量表，用于对精神障碍罪犯的治疗评估（Pr量表），这是一种当地开发的工具，可以测量精神状态的变化以及治疗和管理的变化。接收后不久，将该量表上的分数与在触手可及团队工作一年后的分数进行比较。结果：在2020年新入院的303名男性囚犯中，167人（55%）的物质使用障碍筛查呈阳性，30人（10%）的其他原发性精神障碍筛查呈阴性。其中大多数（n=151）由心理健康服务机构提供并接受护理。1年后，接受该服务的患者在所有Pr量表临床变量方面都有显著改善。结论：我们的研究结果支持将心理筛查扩展到意大利监狱的新接待服务中。他们补充了Pr量表的实用性证据，用于检测那些可能受益于外展服务提供的早期心理健康干预的新入院囚犯，并证明由此产生的变化。未来的研究需要在其他意大利监狱中复制我们的结果，作为系统改进的前兆，而其他国家也可能从常规使用类似的评估和重新评估中受益。

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引用次数: 0

Delays in transferring patients from prisons to secure psychiatric hospitals: An international systematic review 延迟将病人从监狱转移到安全的精神病院：一项国际系统审查。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-09-04 DOI: 10.1002/cbm.2309

Christian P. Sales, Andrew Forrester, John Tully

Background

Transfer to a psychiatric hospital of prisoners who need inpatient treatment for a mental disorder is an important part of prison healthcare in the UK. It is an essential factor in ensuring the principle of equivalence in the treatment of prisoners. In England and Wales, delays in transferring unwell prisoners to hospital were identified by the 2009 Bradley Report. There has been no subsequent systematic review of progress in so doing nor a corresponding appraisal of transfer arrangements in other parts of the world.

Aim

To conduct a systematic review of international literature about transfers of mentally unwell individuals from prison to hospital for the treatment of mental disorder since 2009.

Method

Eight databases were searched for data-based publications using terms for prison and transfer to hospital from 1 January 2009 to 4 August 2022. Inclusion criteria limited transfer to arrangements for pre-trial and sentenced prisoners going to a health service hospital, excluding hospital orders made on the conclusion of criminal hearing.

Results

In England, four articles were identified, all showing that transfer times remain considerably longer than the national targets of 14 days (range, 14 days to >9 months); one study from Scotland found shorter mean transfer times, but more patients had been transferred to psychiatric intensive care units than to secure forensic hospitals. There were only two studies that investigated prison to hospital transfers for mental disorder from outside the UK and only one reported time-to-transfer data.

Conclusions

Findings from this literature review highlight failures to resolve transfer delays in England and provide little evidence about the problem elsewhere. Given the lack of data, it is unclear whether other countries do not have this problem or simply that there has been no research interest in it. A possible confounding factor here is that, in some countries, all treatment for prisoners’ mental disorders occurs in prison. However, the principle that prisons are not hospitals seems important when people need inpatient care. Prospective, longitudinal cohort studies are urgently needed to map transfer times and outcomes.

背景：将因精神障碍需要住院治疗的囚犯转移到精神病院是英国监狱医疗保健的重要组成部分。这是确保囚犯待遇对等原则的一个重要因素。2009年《布拉德利报告》指出，在英格兰和威尔士，将身体不适的囚犯送往医院的工作出现延误。此后没有对这方面的进展进行系统审查，也没有对世界其他地区的转让安排进行相应评估。目的：对2009年以来关于将精神不适者从监狱转移到医院治疗精神障碍的国际文献进行系统回顾。方法：在8个数据库中搜索基于数据的出版物，使用2009年1月1日至2022年8月4日期间监狱和转移到医院的术语。纳入标准仅限于预审和判刑囚犯前往医疗服务医院的安排，不包括刑事听证会结束时下达的医院命令。结果：在英格兰，发现了四篇文章，所有这些文章都表明，转移时间仍远长于14天的国家目标（范围从14天到>9个月）；苏格兰的一项研究发现，平均转移时间更短，但被转移到精神病重症监护室的患者比被转移到安全的法医医院的患者更多。只有两项研究调查了从英国境外将精神障碍患者从监狱转移到医院的情况，只有一项报告了转移数据的时间。结论：这篇文献综述的结果突出了在英格兰未能解决转会延误问题，而在其他地方几乎没有提供关于这一问题的证据。由于缺乏数据，目前尚不清楚其他国家是否没有这个问题，或者只是对它没有研究兴趣。一个可能的混淆因素是，在一些国家，所有囚犯精神障碍的治疗都发生在监狱里。然而，当人们需要住院治疗时，监狱不是医院这一原则似乎很重要。迫切需要前瞻性的纵向队列研究来绘制转移时间和结果。

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引用次数: 0

Implications of sexual fantasy characteristics and memory intensity for harmful sexual behaviour 性幻想特征和记忆强度对有害性行为的影响。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-09-01 DOI: 10.1002/cbm.2308

Andrew Allen, Mary Katsikitis, Prudence Millear, Nadine McKillop

Background

Sexual fantasies and memories are aetiological considerations in the perpetration of sexual violence, but fantasy–memory–behaviour relationships may be influenced by various factors, including sexual fantasy and memory phenomenology, that are the properties of mental imagery.

Aims

To investigate differences in sexual fantasy phenomenology and sexual memory intensity in men who report a history of harmful sexual behaviour compared to those who do not. We also investigated whether the likelihood of reporting harmful sexual intent was related to sexual memory intensity, independently of age and harmful sexual behaviour history.

Methods

An online cross-sectional survey design was used, focusing on men aged ≥18 years who were recruited from the general population via social media. The survey prompted participants to envisage a favoured sexual fantasy, then obtained data on fantasy phenomenology, including vividness and sensations, and arousal level. In addition, information was requested about sexual memory intensity and harmful sexual behaviour history and intent.

Results

A total of 322 men completed the survey. Multiple Welch's t-tests showed that men self-reporting one or more harmful sexual behaviours, such as rape or child sexual abuse, gave significantly higher ratings of sexual fantasy phenomenology but not fantasy frequency or masturbation. They were also more likely to report higher sexual memory intensity. Although the significance of fantasy phenomenology varied between subgroups, binary logistic regression indicated that age, history of harmful sexual behaviour and sexual memory intensity were each independently associated with harmful sexual intent.

Conclusions

Our findings provide new insights into the importance of fantasy phenomenology, demonstrating nuanced differences between those with and without a history of harmful sexual behaviour and illustrating that memory intensity is associated with harmful sexual behaviour intent. Further research into these differences in the context of assessment and intervention for sexual violence perpetration is warranted.

背景：性幻想和性记忆是实施性暴力的病因考虑因素，但幻想-记忆-行为关系可能受到各种因素的影响，包括性幻想和记忆现象学，这是心理意象的特性。目的：调查报告有有害性行为史的男性与未报告的男性在性幻想现象学和性记忆强度方面的差异。我们还调查了报告有害性意图的可能性是否与性记忆强度有关，与年龄和有害性行为史无关。方法：采用在线横断面调查设计，重点关注通过社交媒体从普通人群中招募的年龄≥18岁的男性。该调查促使参与者设想一种受欢迎的性幻想，然后获得幻想现象学的数据，包括生动性和感觉，以及唤醒水平。此外，还要求提供关于性记忆强度和有害性行为历史和意图的信息。结果：共有322名男性完成了调查。多项Welch t检验表明，男性自我报告一种或多种有害的性行为，如强奸或儿童性虐待，对性幻想现象学的评分明显更高，但对幻想频率或手淫的评分则不高。他们也更有可能报告更高的性记忆强度。尽管幻想现象学的意义因亚组而异，但二元逻辑回归表明，年龄、有害性行为史和性记忆强度均与有害性意图独立相关。结论：我们的发现为幻想现象学的重要性提供了新的见解，证明了有和没有有害性行为史的人之间的细微差异，并说明记忆强度与有害性行为意图有关。有必要在评估和干预性暴力行为的背景下对这些差异进行进一步研究。

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引用次数: 0

Montreal Cognitive Assessment (MoCA): A validation study among prisoners 蒙特利尔认知评估（MoCA）：一项针对囚犯的验证研究。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-08-08 DOI: 10.1002/cbm.2306

Vânia Lima Pereira, Sandra Freitas, Mário R. Simões, Bianca Gerardo

Background

There are numerous scales for screening cognitive performance and thus identification of any potential deficits, but in spite of the vulnerability of the prison population to such problems, there has been no adequate validation of screening tools specifically for use with prisoners or others in the criminal justice system.

Aim

To validate the Montreal Cognitive Assessment (MoCA) for use with prisoners.

Methods

100 adult prisoners in one Portuguese prison were randomly invited by clinicians to take part in this study. A same size sample of community-living adult non-offenders of similar age was selected from the MoCA's normative study database in Portugal. For both groups, the key inclusion criterion was fluency in the Portuguese language. All participants completed the Mini Mental State Examination (MMSE) and the MoCA, both in Portuguese translation. Cronbach's alpha coefficient was calculated as an index of internal consistency and Pearson's r correlations calculated. Group performances were compared using independent samples t-test. Covariance analysis (ANCOVA) was computed with level of education as covariate. To measure the magnitude of the effect, $� � � �_{η}^{�} � � �$ was used. A receiver operating characteristics curve analysis was computed to evaluate the discriminatory accuracy of MoCA and MMSE.

Results

The MoCA showed a ‘reasonable’ internal consistency index (α = 0.75) as well as positive and significant correlations with the MMSE. As a cognitive measure, however, the MoCA showed consistently superior psychometric properties and higher discriminatory accuracy (MoCA = 89%) than the MMSE (65%). According to the Youden index, the optimal cut-off point for the MoCA is below 24 points, whereas for the MMSE, it is below 27.

Conclusions

The MoCA is a valid cognitive screening tool for use with prisoners. Further validations against detailed cognitive evaluation would be a useful next step.

背景：有许多量表可以用来筛查认知表现，从而识别任何潜在的缺陷，但尽管监狱人口容易受到这些问题的影响，但还没有充分验证专门用于囚犯或刑事司法系统中其他人的筛查工具。目的：验证蒙特利尔认知评估（MoCA）在囚犯中的应用。方法：临床医生随机邀请葡萄牙一所监狱的100名成年囚犯参加本研究。从葡萄牙MoCA的规范性研究数据库中选择了一个相同规模的年龄相仿的社区生活成年非罪犯样本。对于这两组人来说，关键的入选标准是葡萄牙语的流利程度。所有参与者都完成了小型精神状态检查（MMSE）和MoCA，均为葡萄牙语翻译。计算Cronbach的α系数作为内部一致性指数，并计算Pearson的r相关性。使用独立样本t检验比较各组表现。协方差分析（ANCOVA）以教育水平为协变量进行计算。为了测量效应的大小，使用了ηp 2$｛eta｝_｛p｝^｛2｝$。计算了受试者工作特性曲线分析，以评估MoCA和MMSE的判别准确性。结果：MoCA显示出“合理”的内部一致性指数（α=0.75），并且与MMSE呈正相关。然而，作为一种认知测量，MoCA始终表现出优于MMSE（65%）的心理测量特性和更高的辨别准确性（MoCA=89%）。根据Youden指数，MoCA的最佳临界点低于24分，而MMSE的最佳临界值低于27分。结论：MoCA是一种有效的囚犯认知筛查工具。根据详细的认知评估进行进一步的验证将是有用的下一步。

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引用次数: 0

Prevalence of psychiatric disorders among sentenced prisoners in a medium security prison in Ghana: Implications for mental health assessment and service 加纳一所中等安全级别监狱中被判刑囚犯的精神障碍患病率：对心理健康评估和服务的影响。

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-08-07 DOI: 10.1002/cbm.2307

Gordon M. Donnir, Winifred Asare-Doku

Background

Extant literature has shown that there is a higher prevalence of mental disorders among prisoners compared to the general population. These findings have, however, mostly been from high-income and westernised cultures. In Ghana, little is known about the extent of psychiatric disorders among prisoners, as is consistent with the dearth of scholarly work in low and middle-income countries.

Aims

Our aim was to determine the prevalence of common mental disorders among sentenced prisoners in the second largest prison in Ghana.

Methods

A cross-sectional survey research design was used in one prison. The Mini International Neuro-Psychiatric Interview questionnaire was used to collect data from men and women serving prison sentences who volunteered for the study. Socio-demographic characteristics and criminal history data were collected using a questionnaire designed by the researchers.

Results

Five hundred prisoners participated. Nearly half (246, 49.8%) had at least one psychiatric disorder. The most prevalent disorders were major depression and a range of anxiety disorders (145, 29%, 132, 26% respectively). A smaller proportion recorded high scores on the antisocial personality disorder scale (13%); just 50 (10%) reported using substances in the 12 months before interview, but this is a minimum estimate of such problems as many were already in prison during that time. None of these prisoners, regardless of disorder, had been screened, diagnosed, or treated in prison.

Conclusions

This study contributes to the gap in scholarly literature in low- and middle-income countries on psychiatric disorders in the prison population. It will be important to explore further the extent to which the internationally recognised screening tools used led to under-estimation of psychiatric disorders. The findings are of immediate practical importance nationally as they highlight the need to implement reforms anticipated by the new mental health legislation of 2012 and strategies for interagency working to improve health services and their uptake in the criminal justice system.

背景：现有文献表明，与普通人群相比，囚犯中的精神障碍患病率更高。然而，这些发现大多来自高收入和西方文化。在加纳，人们对囚犯中精神障碍的程度知之甚少，这与低收入和中等收入国家缺乏学术工作相一致。目的：我们的目的是确定加纳第二大监狱被判刑囚犯中常见精神障碍的患病率。方法：采用横断面调查研究设计对某监狱进行调查。迷你国际神经-精神病访谈问卷用于收集自愿参加该研究的服刑男女的数据。社会人口特征和犯罪史数据是使用研究人员设计的问卷收集的。结果：有500名囚犯参加。近一半（246人，49.8%）至少有一种精神障碍。最常见的疾病是严重抑郁症和一系列焦虑症（分别为145、29%、132、26%）。一小部分人在反社会人格障碍量表上获得高分（13%）；在采访前的12个月里，只有50人（10%）报告使用了药物，但这是对此类问题的最低估计，因为许多人在那段时间已经入狱。这些囚犯，无论是否有精神障碍，都没有在监狱中接受过筛查、诊断或治疗。结论：这项研究填补了中低收入国家关于监狱人口精神障碍的学术文献的空白。重要的是要进一步探索国际公认的筛查工具在多大程度上导致对精神障碍的低估。这些发现在全国范围内具有直接的实际意义，因为它们强调了实施2012年新的心理健康立法所预期的改革的必要性，以及机构间努力改善医疗服务及其在刑事司法系统中的应用的战略。

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引用次数: 0

Conducting prison-based research during the COVID-19 pandemic and the value of involving people with lived experience 在2019冠状病毒病大流行期间开展基于监狱的研究，以及让有亲身经历的人参与的价值

IF 1.2 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health

Pub Date : 2023-07-19 DOI: 10.1002/cbm.2305

Daniel Pratt, Rebecca Crook

引用次数: 0

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

IF 1.2 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

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.

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。

{"title":"Difference between forensic patients with schizophrenia spectrum disorders in Italy and other European countries: Results of the EU-VIORMED project","authors":"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","doi":"10.1002/cbm.2302","DOIUrl":"10.1002/cbm.2302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47362,"journal":{"name":"Criminal Behaviour and Mental Health","volume":"33 4","pages":"243-260"},"PeriodicalIF":1.2,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbm.2302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9918606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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