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Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls

Background: Long-term violent re-offending in forensic psychiatric (FP) patients vs. non-FP offenders is largely unknown. Methods: We studied rates and facets of long-term violent reoffending among 1,062 violent forensic psychiatric examinees (FPE) consecutively undergoing pre-trial, forensic psychi...

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Autores principales: Bengtson, Susanne, Lund, Jens, Ibsen, Michael, Långström, Niklas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806391/
https://www.ncbi.nlm.nih.gov/pubmed/31681032
http://dx.doi.org/10.3389/fpsyt.2019.00715
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author Bengtson, Susanne
Lund, Jens
Ibsen, Michael
Långström, Niklas
author_facet Bengtson, Susanne
Lund, Jens
Ibsen, Michael
Långström, Niklas
author_sort Bengtson, Susanne
collection PubMed
description Background: Long-term violent re-offending in forensic psychiatric (FP) patients vs. non-FP offenders is largely unknown. Methods: We studied rates and facets of long-term violent reoffending among 1,062 violent forensic psychiatric examinees (FPE) consecutively undergoing pre-trial, forensic psychiatric examination (FPE) in Denmark during 1980–1992. Altogether, 392 were sentenced to FP treatment (FPE+T); the remaining 670 examinees received ordinary non-FP sanctions (FPE-T). FPE+T were compared to 392 contemporary matched violent general offenders (GEN) without FPE or other psychiatric contacts and sentenced to ordinary non-FP sanctions. FPE data were linked to population-based registers with sociodemographic, psychiatric, and crime information, and we estimated relative risks controlling for birth year, sex, educational and marital status, and previous violent crime. Results: During follow-up (mean = 18.0–19.5 years), FPE+T and GEN had any violent recidivism rates of 43% vs. 29% [adjusted hazard ratio (aHR) = 1.5; 95% CI, 1.1–1.9], respectively. Corresponding findings for severe violence (21% vs. 14%; aHR = 1.3; 95% CI, 0.9–1.9) and recurrent violence (3+ violent convictions; 16% vs. 6%; adjusted odds ratio [aOR] = 2.5; 95% CI, 1.5–4.4) also suggested weakly to moderately increased risks in FPE+T, albeit non-significantly for the former. Comparing FPE+T to FPE-T suggested decreased risk of any violence (43% vs. 51%; aHR = 0.8; 95% CI, 0.6–1.1), severe (21% vs. 34%; aHR = 0.6; 95% CI, 0.4–0.8), and recurrent violence [16% vs. 22%; adjusted odds ratio (aOR) = 0.7; 95% CI, 0.5–1.0] in FP patients, though non-significantly for any violence and recurrent violence. Among all FPE examinees, violent reoffending was independently predicted by male sex, younger age, pre-index violent crime, personality disorder (vs. schizophrenia spectrum and other psychiatric disorder), substance use disorder, and 5+ hospital admissions. Conclusion: FPE examinees, untreated followed by treated, reoffend violently more often than GENs. Similar trends are suggested also for severe and recurrent violence suggesting a need for continua of services for FPE examinees, independently of medico-legal status (i.e., sentencing to treatment or not).
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spelling pubmed-68063912019-11-01 Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls Bengtson, Susanne Lund, Jens Ibsen, Michael Långström, Niklas Front Psychiatry Psychiatry Background: Long-term violent re-offending in forensic psychiatric (FP) patients vs. non-FP offenders is largely unknown. Methods: We studied rates and facets of long-term violent reoffending among 1,062 violent forensic psychiatric examinees (FPE) consecutively undergoing pre-trial, forensic psychiatric examination (FPE) in Denmark during 1980–1992. Altogether, 392 were sentenced to FP treatment (FPE+T); the remaining 670 examinees received ordinary non-FP sanctions (FPE-T). FPE+T were compared to 392 contemporary matched violent general offenders (GEN) without FPE or other psychiatric contacts and sentenced to ordinary non-FP sanctions. FPE data were linked to population-based registers with sociodemographic, psychiatric, and crime information, and we estimated relative risks controlling for birth year, sex, educational and marital status, and previous violent crime. Results: During follow-up (mean = 18.0–19.5 years), FPE+T and GEN had any violent recidivism rates of 43% vs. 29% [adjusted hazard ratio (aHR) = 1.5; 95% CI, 1.1–1.9], respectively. Corresponding findings for severe violence (21% vs. 14%; aHR = 1.3; 95% CI, 0.9–1.9) and recurrent violence (3+ violent convictions; 16% vs. 6%; adjusted odds ratio [aOR] = 2.5; 95% CI, 1.5–4.4) also suggested weakly to moderately increased risks in FPE+T, albeit non-significantly for the former. Comparing FPE+T to FPE-T suggested decreased risk of any violence (43% vs. 51%; aHR = 0.8; 95% CI, 0.6–1.1), severe (21% vs. 34%; aHR = 0.6; 95% CI, 0.4–0.8), and recurrent violence [16% vs. 22%; adjusted odds ratio (aOR) = 0.7; 95% CI, 0.5–1.0] in FP patients, though non-significantly for any violence and recurrent violence. Among all FPE examinees, violent reoffending was independently predicted by male sex, younger age, pre-index violent crime, personality disorder (vs. schizophrenia spectrum and other psychiatric disorder), substance use disorder, and 5+ hospital admissions. Conclusion: FPE examinees, untreated followed by treated, reoffend violently more often than GENs. Similar trends are suggested also for severe and recurrent violence suggesting a need for continua of services for FPE examinees, independently of medico-legal status (i.e., sentencing to treatment or not). Frontiers Media S.A. 2019-10-16 /pmc/articles/PMC6806391/ /pubmed/31681032 http://dx.doi.org/10.3389/fpsyt.2019.00715 Text en Copyright © 2019 Bengtson, Lund, Ibsen and Långström http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Bengtson, Susanne
Lund, Jens
Ibsen, Michael
Långström, Niklas
Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls
title Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls
title_full Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls
title_fullStr Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls
title_full_unstemmed Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls
title_short Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls
title_sort long-term violent reoffending following forensic psychiatric treatment: comparing forensic psychiatric examinees and general offender controls
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6806391/
https://www.ncbi.nlm.nih.gov/pubmed/31681032
http://dx.doi.org/10.3389/fpsyt.2019.00715
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