Streb Judith, Lutz Maximilian, Dudeck Manuela, Klein Verena, Maaß Christina, Fritz Michael, Franke Irina
Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.
Department of Forensic Psychiatry and Psychotherapy, kbo-Isar-Amper-Hospitals, Munich, Germany.
Front Psychiatry. 2022 Mar 23;13:857468. doi: 10.3389/fpsyt.2022.857468. eCollection 2022.
Women in detention remain a widely understudied group. Although the number of studies in women in prison has grown in the past decade, research on female forensic psychiatric inpatients has not increased, and women are in the minority in forensic psychiatry not only as patients but also as examinees. Consequently, most treatment manuals and risk assessments were developed in male samples and apply to male offenders. However, the same treatment and risk assessment rationale can be applied in male and female mentally ill offenders only if evidence shows that no relevant sex differences exist.
The aim of the present study was to examine a sample of male and female forensic psychiatric inpatients with substance use disorders and to compare the socio-demographic, legal, and clinical characteristics between the sexes.
The sample included 115 male and 61 female patients. All patients were in mandatory inpatient forensic psychiatry treatment according to section 64 of the German penal code.
We found no significant differences between men and women in terms of educational status and vocational training. However, women were more often single and less likely to be employed full time, and they reported adverse childhood experiences more often than men. Regarding clinical variables, women appeared to be less likely to have a substance use disorder due to alcohol use and had more previous psychiatric treatments than men. Male patients were significantly younger on first conviction and detention, had more criminal records and served longer total penalties than female patients. Furthermore, men committed more violent crimes and women, more narcotics-related crimes.
The study identified sex-specific differences in forensic psychiatric patients that should be considered in the context of forensic therapy.
被拘留女性仍然是一个研究广泛不足的群体。尽管在过去十年中，关于监狱女性的研究数量有所增加，但对女性法医精神病住院患者的研究并未增加，而且在法医精神病学领域，女性不仅作为患者，而且作为受检者都占少数。因此，大多数治疗手册和风险评估都是基于男性样本制定的，适用于男性罪犯。然而，只有当证据表明不存在相关性别差异时，相同的治疗和风险评估原理才能应用于男性和女性精神病罪犯。
本研究的目的是对患有物质使用障碍的男性和女性法医精神病住院患者进行抽样调查，并比较两性之间的社会人口统计学、法律和临床特征。
样本包括115名男性患者和61名女性患者。所有患者均根据德国刑法典第64条接受强制性住院法医精神病治疗。
我们发现，男性和女性在教育程度和职业培训方面没有显著差异。然而，女性更常单身，全职就业的可能性较小，而且她们报告的童年不良经历比男性更多。在临床变量方面，女性因饮酒导致物质使用障碍的可能性似乎较小，并且比男性有更多的既往精神病治疗史。男性患者首次定罪和被拘留时明显更年轻，有更多犯罪记录，总刑期比女性患者更长。此外，男性实施的暴力犯罪更多，而女性实施的与毒品相关的犯罪更多。
该研究确定了法医精神病患者中的性别差异，在法医治疗中应予以考虑。
