Krona Hedvig, Nyman Marielle, Andreasson Helena, Vicencio Nicolas, Anckarsäter Henrik, Wallinius Märta, Nilsson Thomas, Hofvander Björn
a Lund University, Department of Clinical Sciences , Lund , Sweden.
b Institute of Neuroscience and Physiology, Department of Forensic Psychiatry and Center of Ethics, Law and Mental Health , University of Gothenburg , Sweden.
Nord J Psychiatry. 2017 Feb;71(2):102-109. doi: 10.1080/08039488.2016.1236400. Epub 2016 Oct 5.
Forensic psychiatric patients present a challenge as they manifest severe mental disorders together with criminal behaviour. There are well-known risk factors for criminal behaviour in the general population, yet knowledge of what predicts reconviction in the Swedish forensic population in the long-term perspective is still insufficient.
The study aims to (1) describe background and clinical characteristics of forensic psychiatric patients in a 10-year follow-up, (2) analyse risk factors associated with recidivism, and (3) test the predictive validity of risk factors for general and violent criminality.
Detailed information on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment from 1999-2005 (n = 125) was collected. Court decisions were collected up until the end of 2008 (median follow-up time = 6.2 years, range = 0.6-9.7 years).
Relapse in general crime (n = 30) was predicted by low educational attainment, mental disorder in a first degree relative, and low age at first sentenced crime. Relapse in violent crime (n = 16) was predicted by low educational attainment and low GAF scores. Patients with a restriction order were less likely to relapse in both crime categories.
Signs of childhood adversities together with early debut in criminality appeared as important risk factors for general and violent recidivism. Forensic psychiatric treatment combined with a restriction order was demonstrated as a protective factor against recidivism, suggesting that the risk of recidivism is strongly related to the level of supervision. Although the low number of recidivism cases is highly desirable, it unfortunately reduces the power of the analyses in this paper.
法医精神病患者带来了挑战，因为他们既表现出严重的精神障碍又有犯罪行为。在普通人群中存在众所周知的犯罪行为风险因素，但从长期角度来看，对于瑞典法医人群中预测再次定罪的因素的了解仍然不足。
本研究旨在（1）描述法医精神病患者在10年随访中的背景和临床特征，（2）分析与累犯相关的风险因素，以及（3）测试风险因素对一般犯罪和暴力犯罪的预测效度。
收集了1999年至2005年在马尔默大学医院辖区内被判处法医精神病住院治疗的所有罪犯（n = 125）的详细信息。收集法庭判决直至2008年底（中位随访时间 = 6.2年，范围 = 0.6 - 9.7年）。
一般犯罪（n = 30）的复发可由低教育程度、一级亲属患有精神障碍以及首次被判刑犯罪时年龄较小预测。暴力犯罪（n = 16）的复发可由低教育程度和低GAF评分预测。有禁制令的患者在这两类犯罪中复发的可能性较小。
童年逆境迹象以及犯罪行为的早期出现似乎是一般和暴力累犯的重要风险因素。法医精神病治疗结合禁制令被证明是预防累犯的保护因素，这表明累犯风险与监管水平密切相关。尽管累犯案例数量少是非常理想的，但不幸的是，这降低了本文分析的效力。
