Researcher, Department South, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark.
Can J Psychiatry. 2013 Sep;58(9):515-21. doi: 10.1177/070674371305800906.
It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients with schizophrenia.
Danish patients with schizophrenia (18 years or older) discharged from a psychiatric ward between January 2004 and March 2009 were identified using a national population-based schizophrenia registry (n = 10 757). Data for in-hospital care and patient characteristics were linked with data on criminal charges obtained from the Danish Crime Registry until November 2010.
Twenty per cent (n = 2175) of patients were charged with a crime during follow-up (median = 428 days). Violent crimes accounted for 59% (n = 1282) of the criminal offences. The lowest risk of crime was found among patients receiving the most processes of in-hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment and staff contact with relatives.
High-quality, in-hospital psychiatric care was associated with a lower risk of criminal behaviour after discharge among patients with schizophrenia.
目前尚不清楚基于证据的住院治疗过程是否会影响精神分裂症患者的犯罪行为风险。本研究旨在探讨指南推荐的住院精神科护理与精神分裂症患者犯罪行为之间的关联。
使用全国基于人群的精神分裂症登记处，确定了 2004 年 1 月至 2009 年 3 月期间从精神病病房出院的丹麦精神分裂症患者（18 岁及以上）（n=10757）。住院护理和患者特征的数据与从丹麦犯罪登记处获得的犯罪指控数据相关联，直至 2010 年 11 月。
在随访期间，20%（n=2175）的患者被指控犯罪（中位数=428 天）。暴力犯罪占犯罪行为的 59%（n=1282）。接受住院治疗过程最多的患者犯罪风险最低（与接受建议护理的最低四分位相比，最高四分位的调整后危害比=0.86，95%置信区间 0.75 至 0.99）。与犯罪行为风险最低相关的个别护理过程是抗精神病药物治疗和工作人员与亲属的接触。
高质量的住院精神科护理与精神分裂症患者出院后犯罪行为风险降低相关。
