Kusters I, van Horn J E, Cnossen T E A
Tijdschr Psychiatr. 2018;60(10):672-681.
Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient forensic care in The Netherlands.
AIM: Since 2007, Dutch forensic (flexible) assertive community treatment (For(F)ACT) teams offer outpatient, intensive treatment to forensic clients with complex mental health issues. As the need for this form of intensive treatment increases, so does the need for unambiguous indication criteria to facilitate adequate care and accompanied reduction in criminal behavior.
METHOD: The present study investigated the correlation between the clinical indication criteria and risk factors for criminal behavior in 76 For(F)ACT-clients, reviewing which criteria best predicted recidivism.
RESULTS: A weak correlation was found between the indication criteria and risk factors. Further receiver operating characteristic (ROC) analysis showed that a combination of clinical indication criteria best predicted recidivism.
CONCLUSION: The influential risk factors for For(F)ACT-clients are different compared to those for other groups of delinquents. Important treatment factors are breaking patterns, increasing safety and offering social and financial support. The clinical indication criteria should not be replaced by the START risk factors.
普通精神病学和法医精神病学临床床位的削减增加了荷兰门诊法医护理的负担。
自2007年以来，荷兰法医（灵活）积极社区治疗（For(F)ACT）团队为患有复杂心理健康问题的法医客户提供门诊强化治疗。随着对这种强化治疗形式的需求增加，对明确的适应症标准的需求也随之增加，以促进充分的护理并减少犯罪行为。
本研究调查了76名For(F)ACT客户的临床适应症标准与犯罪行为风险因素之间的相关性，审查哪些标准最能预测再犯。
发现适应症标准与风险因素之间存在弱相关性。进一步的受试者工作特征（ROC）分析表明，临床适应症标准的组合最能预测再犯。
For(F)ACT客户的有影响力的风险因素与其他青少年群体不同。重要的治疗因素是打破模式、提高安全性以及提供社会和经济支持。临床适应症标准不应被START风险因素所取代。
