Kramp Peter, Gabrielsen Gorm
Retspsykiatrisk Klinik, Blegdamsvej 6B, DK-2200 Kobenhavn.
Ugeskr Laeger. 2003 Jun 16;165(25):2553-6.
In line with many other countries, Denmark has reorganised psychiatric care with closure of 50% of the psychiatric beds in favour of community mental health. Parallel to this reorganisation the number of forensic patients has increased.
In Denmark, the majority of forensic patients are under supervision by a probation officer. As from 1977, The Department of Prison and Probation has registered the monthly prevalence of forensic patients, from 1989 also the monthly incidence and decrease. These data have been used to analyse the trends in the number of forensic patients.
The number of forensic patients increased from 297 in 1980 to 1134 in 1999, the increase in prevalence being exponential with an annual growth rate of 6.79%. The incidence figures showed an exponential increase with an annual growth rate of 5.96% (95% confidence interval 4.76%-7.27%). The annual growth rate for the decrease is 6.18%. Thus, the three growth rates do not differ, meaning that the increasing number of forensic patients is the result of an increasing intake.
The growing number of mentally ill offenders cannot be explained by changes of the Danish penal law concerning mentally abnormal offenders nor by changes in administrative or diagnostic practice. The number of reported crimes in Denmark has remained unchanged from 1987. The main reason for the exponential growth rate is an increasing number of schizophrenic patients committing crimes. It is concluded that deinstitutionalisation is the main reason for this development.
与许多其他国家一样,丹麦对精神科护理进行了重组,关闭了50%的精神科床位,转而支持社区心理健康服务。在这次重组的同时,法医鉴定患者的数量有所增加。
在丹麦,大多数法医鉴定患者由一名缓刑监督官监管。自1977年以来,监狱与缓刑部每月都会记录法医鉴定患者的患病率,从1989年起还记录每月的发病率和减少率。这些数据已用于分析法医鉴定患者数量的趋势。
法医鉴定患者的数量从1980年的297人增加到1999年的1134人,患病率呈指数增长,年增长率为6.79%。发病率数据呈指数增长,年增长率为5.96%(95%置信区间4.76%-7.27%)。减少率的年增长率为6.18%。因此,这三个增长率没有差异,这意味着法医鉴定患者数量的增加是由于入院人数增加所致。
丹麦刑法中关于精神异常罪犯的规定变化、行政或诊断实践的变化,都无法解释患有精神疾病的罪犯数量为何增加。丹麦自1987年以来报告的犯罪数量一直保持不变。增长率呈指数增长的主要原因是犯罪的精神分裂症患者数量增加。得出的结论是,非机构化是这一发展的主要原因。