Fazel Seena, Grann Martin
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Int J Geriatr Psychiatry. 2002 Oct;17(10):907-13. doi: 10.1002/gps.715.
We retrospectively examined psychiatric diagnoses of older offenders referred by court for psychiatric assessment in Sweden, and compared them with younger offenders.
In Sweden, structured court-ordered forensic psychiatric evaluations are undertaken by a forensic psychiatric team. Data on age, sex, citizenship, psychiatric diagnoses, offences, and legal insanity declarations were obtained for the years 1988-2000 (n = 7297).
There were 210 forensic psychiatric evaluations in those aged 60 and over. 7% had a diagnosis of dementia, 32% psychotic illness, 8% depressive or anxiety disorder, 15% substance abuse or dependence, and 20% personality disorder. Older offenders were significantly less likely to be diagnosed with schizophrenia or a personality disorder, and more likely to have dementia or an affective psychosis compared to younger ones. Logistic regression analyses suggested that of the studied factors, the ones most typical of older offenders were a diagnosis of dementia and being charged with a sexual offence.
There appear to be important differences in psychiatric morbidity between older offenders and younger ones who come into contact with forensic psychiatric services. This research may assist in the planning of forensic and therapeutic services for the increasing number of older adults passing through the criminal justice system.
我们回顾性研究了瑞典法院转介进行精神病学评估的老年罪犯的精神疾病诊断,并将他们与年轻罪犯进行比较。
在瑞典,由法医精神病学团队进行结构化的法院命令的法医精神病学评估。获取了1988 - 2000年(n = 7297)关于年龄、性别、公民身份、精神疾病诊断、犯罪行为和法律精神错乱声明的数据。
60岁及以上的人群中有210例法医精神病学评估。7%被诊断为痴呆,32%为精神疾病,8%为抑郁或焦虑障碍,15%为药物滥用或依赖,20%为人格障碍。与年轻罪犯相比,老年罪犯被诊断为精神分裂症或人格障碍的可能性显著降低,而患痴呆或情感性精神病的可能性更高。逻辑回归分析表明,在所研究的因素中,老年罪犯最典型的因素是痴呆诊断和被控性犯罪。
接触法医精神病学服务的老年罪犯和年轻罪犯在精神疾病发病率方面似乎存在重要差异。这项研究可能有助于为越来越多通过刑事司法系统的老年人规划法医和治疗服务。