New England Mental Illness, Research, and Clinical Care Center, VA Connecticut Healthcare System, West Haven, CT, USA.
Community Ment Health J. 2011 Dec;47(6):727-36. doi: 10.1007/s10597-010-9362-9. Epub 2010 Nov 28.
There is growing concern that people with schizophrenia and other severe mental illnesses are increasingly at risk for unnecessary criminal justice system (CJS) involvement. There has been limited examination, however, of which individual characteristics predict future CJS involvement. This study uses data from the Clinical Antipsychotic Trials of Intervention Effectiveness on sociodemograhic characteristics, baseline clinical status, and service use among patients diagnosed with schizophrenia to prospectively identify predictors of CJS involvement during the following year. A series of bivariate chi-square and F tests were conducted to examine whether significant relationships existed between CJS involvement during the first 12 months of the trial and baseline measures of sociodemographic characteristics, psychiatric status, substance abuse, and other patient characteristics. Multivariate logistic regression analysis was then used to identify the independent strength of the relationship between 12-month CJS involvement and potential risk factors that were found to be significant in bivariate analyses. Multivariate logistic regression analyses indicated that past adolescent conduct disorder, being younger and male, symptoms of Akathisia (movement disorder, most often develops as a side effect of antipsychotic medications), and particularly drug abuse increase the risk for CJS involvement. Since CJS involvement among people with schizophrenia was most strongly associated with drug abuse, treatment of co-morbid drug abuse could reduce the risk of stigma, pain, and other adverse consequences of CJS involvement as well as save CJS expenditures.
越来越多的人担心精神分裂症和其他严重精神疾病患者越来越容易不必要地卷入刑事司法系统 (CJS)。然而,对于哪些个体特征可以预测未来的 CJS 卷入,目前的研究还很有限。本研究使用了来自临床抗精神病药物干预有效性试验的患者人口统计学特征、基线临床状况和服务使用数据,前瞻性地确定了在接下来的一年中与 CJS 卷入相关的预测因素。通过一系列的卡方检验和 F 检验,我们检验了在试验的前 12 个月期间 CJS 卷入与基线人口统计学特征、精神状态、药物滥用和其他患者特征之间是否存在显著关系。然后,我们使用多元逻辑回归分析来确定与 12 个月 CJS 卷入相关的独立关系强度,以及在双变量分析中发现的潜在风险因素。多元逻辑回归分析表明,过去青少年行为障碍、年龄较小和男性、静坐不能(运动障碍,最常作为抗精神病药物的副作用发展)的症状,特别是药物滥用,会增加 CJS 卷入的风险。由于精神分裂症患者的 CJS 卷入与药物滥用关系最为密切,因此治疗共病药物滥用可以降低 CJS 卷入带来的耻辱、痛苦和其他不良后果的风险,并节省 CJS 支出。