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- Persson, Mats, et al.
(författare)
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Self-reported violent ideation and its link to interpersonal violence among offenders with mental disorders and general psychiatric patients
- 2018
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Ingår i: Psychiatry Research. - : ELSEVIER IRELAND LTD. - 0165-1781 .- 1872-7123. ; 261, s. 197-203
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Tidskriftsartikel (refereegranskat)abstract
- This study aims at comparing mentally disordered offenders and general psychiatric patients regarding violent ideation and at exploring its association with interpersonal violence. We recruited 200 detainees undergoing forensic psychiatric evaluation and 390 general psychiatric patients at discharge. At baseline, they were asked about violent ideation; at the 20-week follow-up, information about violent acts was gathered from crime conviction registry, interviews, and records. The lifetime prevalence of violent ideation was 32.5% for offenders and 35.6% for patients; the corresponding two-month prevalence was 22.5% and 21.0%, respectively. For the both samples combined, those with violent ideation in their lifetime were significantly more prone to commit violent acts during follow-up than those without such ideation, OR = 2.65. The same applied to the patient sample, OR = 3.41. In terms of positive predictive values, fewer than 25% of those with violent ideation committed violent acts. Contrary to our hypothesis, the prevalence of violent ideation did not differ significantly between offenders and patients. However, there was support for the hypothesized association between violent ideation and violent acts on a group level. On an individual level, the clinician should consider additional factors when assessing the risk for violent acts.
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| 2. |
- Persson, Mats, et al.
(författare)
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Violence During Imprisonment, Forensic Psychiatric Care, and Probation: Correlations and Predictive Validity of the Risk Assessment Instruments COVR, LSI-R, HCR-20(V3), and SAPROF
- 2017
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Ingår i: International Journal of Forensic Mental Health. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 1499-9013 .- 1932-9903. ; 16:2, s. 117-129
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Tidskriftsartikel (refereegranskat)abstract
- This prospective, naturalistic, cohort study was designed to report the one-year rate of violence among Swedish forensic psychiatric clients, during forensic psychiatric care, prison, and probation. Another purpose was to validate the risk assessment instruments COVR, LSI-R, HCR-20(V3), and SAPROF in these settings. We assessed 200 detainees undergoing a forensic psychiatric investigation in Stockholm by means of the four instruments, 193 of them were followed up for one year. Violent acts were committed by 23.3% of the participants, and occurred more often at forensic psychiatric hospitals than correctional settings. According to the analyses, the predictive validity was small for COVR (AUC = .61), medium for LSI-R (AUC = .70), and large for HCR-20(V3) (AUC = .79) and SAPROF (AUC = .78).
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| 3. |
- Persson, Mats, et al.
(författare)
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Violent victimization and health service utilization in a forensic psychiatric context: a comparison between offenders with mental disorders and matched controls
- 2017
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Ingår i: BMC Psychiatry. - : BIOMED CENTRAL LTD. - 1471-244X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Offenders with mental disorders constitute a particularly exposed group in society, with high rates of morbidity, mortality, and social deprivation. Often thought of primarily as perpetrators, these individuals may also be subjected to violence. Previous research indicates that violent victimization during lifespan is a risk factor for violent perpetration among psychiatric patients, but victimization studies on the group of offenders with mental disorders are scarce. Health services are pivotal to this group, but although most individuals do utilize these services, their vulnerability seems to remain. This study aimed at exploring the rates of victimization and health service utilization, including perceptions of unmet health care needs, among offenders with mental disorders. Methods: Two hundred detainees undergoing a forensic psychiatric evaluation in Stockholm were asked about violent victimization and health service utilization. Each detainee was compared with three controls from the general population, matched regarding age, sex, and occupation. Results: Victimization during the past year was reported by 52.3% of the detainees and 11.1% of the controls, with a corresponding risk ratio of 8.2. Health service utilization during the past three months was reported by 47.7 and 23.7%, respectively (risk ratio 2.0); and unmet health care needs by 42.2 and 16.7%, respectively (risk ratio 3.4). There was no distinct association between victimization and health service utilization among detainees. Conclusions: Offenders with mental disorders are at great risk of being victimized, and they experience impediments to receiving requisite health care. A possible way to reduce victimization and improve health service utilization may be to establish interdisciplinary yet specialized health centers with outreach teams but without complicated referral procedures.
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| 4. |
- Sygel, Kristina, et al.
(författare)
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The effect of gender on the outcome of forensic psychiatric assessment in Sweden : A case vignette study
- 2017
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Ingår i: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 27:2, s. 124-135
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious research suggests that female violent offenders at risk of a prison sentence are more likely than their male counterparts to be assessed as having mental health problems of a nature or degree that would lead to a court requirement for hospital treatment.Aims/hypothesesTo test the hypothesis that there is bias towards hospital disposal of female compared with male violent offenders with mental disorder.MethodsIn Sweden, the National Board of Forensic Medicine oversees all assessments of mental disorder for the criminal courts. Twenty-six Board appointed forensic psychiatrists, psychologists and social workers each independently assessed six case vignettes for fit with criteria for ‘severe mental disorder’, a prerequisite for hospital disposal from court. Each gender neutral vignette described a person who had been convicted of serious assault and had a major mental disorder. A gender was then assigned to each offender randomly within a block design, thus varying between sets. Participants were blind to the main aim of the study and the gender variation.ResultsThere was no significant association between gender of the person assessed and judgement that s/he had a ‘severe mental disorder’. An offender depicted as having mental retardation was more likely to be assessed as at high risk of criminal recidivism if portrayed as female, regardless of the sex, place of work or level of experience of the assessor.ConclusionWe found no evidence of gender bias in determining appropriateness of a hospital disposal of an offender with mental disorder. The difference in assessment of recidivism according to sex of the patient was only in relation to mental retardation; further research would be needed to able to interpret this. As researchers in other countries have reported gender bias in disposals from court, our findings may provide support for a centralised forensic psychiatric assessment board and formal, on-going training.
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