Oliveira Gustavo C, Valença Alexandre M, de Moraes Talvane M, Mendlowicz Mauro V, Forrest Miles C, Batista Fred F, Mendes Gabriella A, Lima Tiago N, Gonçalves Vinicius R, Mecler Kátia
Unidade de Psiquiatria, Hospital de Base do Distrito Federal, Brasília, DF, Brazil.
Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Braz J Psychiatry. 2017 Jan-Mar;39(1):45-54. doi: 10.1590/1516-4446-2015-1871. Epub 2016 Sep 29.
: To evaluate factors related to dangerousness cessation at the end of involuntary commitment based on an analysis of expert reports. In light of the current legal requirement of dangerousness cessation as a pre-requisite for prison or internment release of individuals subjected to the safety measure, we sought elements to reflect on the practice of expert examiners in charge of making this decision.
: The authors revised 224 expert psychiatric dangerousness cessation reports released 2011 through 2014 and collected data for a statistical analysis.
: The following variables were associated with positive risk cessation assessments: no inadequate behavior (according to the assistant professionals), no productive psychotic symptoms, no negative symptoms, presence of insight, presence of a support network, and no psychoactive substance abuse. The following variables were associated with negative dangerousness cessation decisions: early onset of malfunction, lack of insight, negative attitudes, active signs of major mental illness, presence of impulsiveness, poor response to treatment, presence of plans lacking feasibility, exposure to destabilizing factors, lack of personal support, and presence of stress.
: In this study we were able to identify factors associated with dangerousness in a sample of expert reports. The knowledge of factors linked to a higher risk of recidivism in illegal activities or violent behavior is crucial for decision-making regarding the release of offenders after their legally established period of involuntary commitment.
基于对专家报告的分析,评估与非自愿住院结束时危险性停止相关的因素。鉴于当前将危险性停止作为对采取安全措施的个人进行监狱释放或拘留释放的先决条件这一法律要求,我们寻找了一些要素来反思负责做出这一决定的专家审查员的实践。
作者查阅了2011年至2014年发布的224份专家精神病危险性停止报告,并收集数据进行统计分析。
以下变量与危险性停止的积极评估相关:无不适当行为(根据助理专业人员的判断)、无有效精神病症状、无阴性症状、有洞察力、有支持网络且无精神活性物质滥用。以下变量与危险性停止的消极决定相关:功能障碍早发、缺乏洞察力、消极态度、严重精神疾病的活跃迹象、存在冲动性、对治疗反应不佳、存在缺乏可行性的计划、接触不稳定因素、缺乏个人支持以及存在压力。
在本研究中,我们能够在专家报告样本中识别出与危险性相关的因素。了解与非法活动或暴力行为再犯风险较高相关的因素对于在依法确定的非自愿住院期后对罪犯释放的决策至关重要。