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Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting

OBJECTIVES: Forensic psychiatric care has two, often contradictory, aims—the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate t...

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Autores principales: Gosek, Paweł, Kotowska, Justyna, Rowińska-Garbień, Elżbieta, Bartczak, Dariusz, Heitzman, Janusz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457126/
https://www.ncbi.nlm.nih.gov/pubmed/32922318
http://dx.doi.org/10.3389/fpsyt.2020.00810
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author Gosek, Paweł
Kotowska, Justyna
Rowińska-Garbień, Elżbieta
Bartczak, Dariusz
Heitzman, Janusz
author_facet Gosek, Paweł
Kotowska, Justyna
Rowińska-Garbień, Elżbieta
Bartczak, Dariusz
Heitzman, Janusz
author_sort Gosek, Paweł
collection PubMed
description OBJECTIVES: Forensic psychiatric care has two, often contradictory, aims—the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate treatment. Therefore, identifying the factors affecting the length of stay (LoS) is one of the most important research areas in the forensic psychiatry. The literature on this subject is scarce and to date there no data available on LoS for patients in Eastern or Central European patients. METHODS: We conducted a retrospective analysis of data for 150 inpatients in a medium secure unit. Based on a literature review and clinical experience, variables potentially influencing LoS were identified and included in the analysis. RESULTS: The variables that were significantly associated with LoS included duration of mental illness; severity of index offense; whether a crime was committed as a result of hallucinations or during drug treatment discontinuation; if the index offenses was a continuous crime (crimes committed over an extended period of time); persistent psychosis; multiple antipsychotic treatments; as well as a diagnosis of schizophrenia and schizoaffective disorder. CONCLUSIONS: Our findings are highly consistent with observations made by other researchers. However, contrary the majority of previous studies our project incorporates data concerning the clinical presentation of patients. For example, we demonstrate that variables measuring treatment resistance might be one of the crucial determinants of LoS, which is a novel research finding.
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spelling pubmed-74571262020-09-11 Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting Gosek, Paweł Kotowska, Justyna Rowińska-Garbień, Elżbieta Bartczak, Dariusz Heitzman, Janusz Front Psychiatry Psychiatry OBJECTIVES: Forensic psychiatric care has two, often contradictory, aims—the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate treatment. Therefore, identifying the factors affecting the length of stay (LoS) is one of the most important research areas in the forensic psychiatry. The literature on this subject is scarce and to date there no data available on LoS for patients in Eastern or Central European patients. METHODS: We conducted a retrospective analysis of data for 150 inpatients in a medium secure unit. Based on a literature review and clinical experience, variables potentially influencing LoS were identified and included in the analysis. RESULTS: The variables that were significantly associated with LoS included duration of mental illness; severity of index offense; whether a crime was committed as a result of hallucinations or during drug treatment discontinuation; if the index offenses was a continuous crime (crimes committed over an extended period of time); persistent psychosis; multiple antipsychotic treatments; as well as a diagnosis of schizophrenia and schizoaffective disorder. CONCLUSIONS: Our findings are highly consistent with observations made by other researchers. However, contrary the majority of previous studies our project incorporates data concerning the clinical presentation of patients. For example, we demonstrate that variables measuring treatment resistance might be one of the crucial determinants of LoS, which is a novel research finding. Frontiers Media S.A. 2020-08-14 /pmc/articles/PMC7457126/ /pubmed/32922318 http://dx.doi.org/10.3389/fpsyt.2020.00810 Text en Copyright © 2020 Gosek, Kotowska, Rowińska-Garbień, Bartczak and Heitzman 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
Gosek, Paweł
Kotowska, Justyna
Rowińska-Garbień, Elżbieta
Bartczak, Dariusz
Heitzman, Janusz
Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_full Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_fullStr Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_full_unstemmed Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_short Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_sort factors influencing length of stay of forensic patients: impact of clinical and psychosocial variables in medium secure setting
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457126/
https://www.ncbi.nlm.nih.gov/pubmed/32922318
http://dx.doi.org/10.3389/fpsyt.2020.00810
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