Sökning: L773:1664 0640 OR L773:1664 0640
> Engberg G >
Pharmacological Tre...
Pharmacological Treatment in Forensic Psychiatry-A Systematic Review
-
- Howner, K. (författare)
- Karolinska Institutet,Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden;Natl Board Forens Med, Dept Forens Psychiat, Stockholm, Sweden
-
- Andiné, Peter (författare)
- Gothenburg University,Göteborgs universitet,Centrum för etik, juridik och mental hälsa,Institutionen för neurovetenskap och fysiologi,Centre for Ethics, Law, and Mental Health,Institute of Neuroscience and Physiology,Natl Board Forens Med, Dept Forens Psychiat, Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Psychiat & Neurochem,Ctr Eth Law & Mental Hl, Gothenburg, Sweden;Sahlgrens Univ Hosp, Forens Psychiab Clin, Gothenburg, Sweden
-
- Engberg, G. (författare)
- Karolinska Institutet,Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden
-
visa fler...
-
- Ekstrom, E. H. (författare)
- Swedish Agcy Hlth Technol Assessment & Assessment, Stockholm, Sweden
-
- Lindström, Eva (författare)
- Uppsala universitet,Ekselius: Psykiatri
-
- Nilsson, M. (författare)
- Swedish Agcy Hlth Technol Assessment & Assessment, Stockholm, Sweden
-
- Radovic, Susanna, 1969 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för filosofi, lingvistik och vetenskapsteori,Department of Philosophy, Linguistics and Theory of Science,Univ Gothenburg, Dept Philosophy Linguist Theory Sci, Gothenburg, Sweden
-
- Hultcrantz, M. (författare)
- Swedish Agcy Hlth Technol Assessment & Assessment, Stockholm, Sweden
-
visa färre...
-
(creator_code:org_t)
- 2020-01-16
- 2020
- Engelska.
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 10
- Relaterad länk:
-
https://www.frontier...
-
visa fler...
-
https://doi.org/10.3...
-
https://uu.diva-port... (primary) (Raw object)
-
https://gup.ub.gu.se...
-
https://doi.org/10.3...
-
http://kipublication...
-
https://urn.kb.se/re...
-
visa färre...
Abstract
Ämnesord
Stäng
- Background: Pharmacological treatment is of great importance in forensic psychiatry, and the vast majority of patients are treated with antipsychotic agents. There are several systematic differences between general and forensic psychiatric patients, e.g. severe violent behavior, the amount of comorbidity, such as personality disorders and/or substance abuse. Based on that, it is reasonable to suspect that effects of pharmacological treatments also may differ. The objective of this systematic review was to investigate the effects of pharmacological interventions for patients within forensic psychiatry. Methods: The systematic review protocol was pre-registered in PROSPERO (CRD42017075308). Six databases were used for literature search on January 11, 2018. Controlled trials from forensic psychiatric care reporting on the effects of antipsychotic agents, mood stabilizers, benzodiazepines, antidepressants, as well as pharmacological agents used for the treatment of addiction or ADHD, were included. Two authors independently reviewed the studies, evaluated risk of bias and assessed certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: The literature search resulted in 1783 records (titles and abstracts) out of which 10 studies were included. Most of the studies included were retrospective and non-randomized. Five of them focused on treatment with clozapine and the remaining five on other antipsychotics or mood stabilizers. Five studies with a high risk of bias indicated positive effects of clozapine on time from treatment start to discharge, crime-free time, time from discharge to readmission, improved clinical functioning, and reduction in aggressive behavior. Psychotic symptoms after treatment were more pronounced in the clozapine group. Mainly due to the high risk of bias the reliability of the evidence for all outcomes was assessed as very low. Conclusion: This systematic review highlights the shortage of knowledge on the effectiveness of pharmacological treatment within forensic psychiatry. Due to very few studies being available in this setting, as well as limitations in their execution and reporting, it is challenging to overview the outcomes of pharmacological interventions in this context. The frequent use of antipsychotics, sometimes in combination with other pharmacological agents, in this complex and heterogeneous patient group, calls for high-quality studies performed in this specific setting.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Nyckelord
- forensic psychiatric care
- mentally disordered offenders
- pharmacological treatment
- systematic review
- antipsychotics
- clozapine
- schizophrenia
- violence
- care
- Psychiatry
- forensic psychiatric care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas