佛兰德的高安全设置：对出院及长期法医精神病患者的分析。
High Security Settings in Flanders: An Analysis of Discharged and Long-Term Forensic Psychiatric Patients.
作者信息
Jeandarme Inge, Goktas Gokhan, Boucké Jan, Dekkers Ingrid, De Boel Laurent, Verbeke Geert
机构信息
FPC Antwerp, Antwerp, Belgium.
Department of Law and Criminology, Catholic University of Leuven, Leuven, Belgium.
出版信息
Front Psychiatry. 2022 Jul 5;13:826406. doi: 10.3389/fpsyt.2022.826406. eCollection 2022.
BACKGROUND
Two Forensic Psychiatric Centres (FPC) were implemented the last decade in Flanders in Ghent (2014) and Antwerp (2017). FPCs are forensic institutions for forensic psychiatric patients with a high recidivism risk and a high security need. The objective of FPCs is to create a care process with sufficient flow (from high to lower forms of security), and transitions (from specialized forensic care to regular psychiatric care).
AIMS
To examine the characteristics of the high security population in FPCs, treatment length, number of discharges, and discharge locations and to determine the profile of long-term patients within an FPC.
METHODS
A retrospective file study of an admission cohort of 654 patients admitted to FPC Ghent or FPC Antwerp was conducted. Sociodemographic, clinical, judicial and risk characteristics were analyzed. Bivariate analyses were used to test the difference between two groups: the group that was discharged to a lower security level vs. the group of long-term patients.
RESULTS
Most patients had psychosis and personality disorders, while comorbidity was also high. Judicial histories were extensive, with many sexual index offenses. During a 6-year follow-up period, the number of referrals back to prison was low. Nearly a third of the population was discharged to a setting with a lower security level. Long-term patients typically presented with more personality disorders, higher psychopathy traits and higher risk scores and were more frequently subjected to coercive measures during treatment.
CONCLUSIONS
The Flemish FPC population is characterized by a high proportion of sex offenders as well as a high proportion of personality-disordered patients. It is this last group, and the group with elevated psychopathy traits, who remain for longer than expected and is difficult to resocialize. This study further highlights the need for clear criteria to assess the conditions of these long-term patients in Flanders.
背景
过去十年间，在比利时弗拉芒大区的根特（2014年）和安特卫普（2017年）设立了两家法医精神病中心（FPC）。FPC是针对具有高再犯风险和高安全需求的法医精神病患者的法医机构。FPC的目标是创建一个具有足够流程（从高安全级别到低安全级别）和过渡（从专门的法医护理到常规精神病护理）的护理过程。
目的
研究FPC中高安全级别的人群特征、治疗时长、出院人数、出院地点，并确定FPC内长期患者的概况。
方法
对根特FPC或安特卫普FPC收治的654例患者的入院队列进行回顾性档案研究。分析了社会人口统计学、临床、司法和风险特征。采用双变量分析来检验两组之间的差异：出院至较低安全级别的组与长期患者组。
结果
大多数患者患有精神病和人格障碍，同时合并症也很高。司法病史广泛，有许多性指数犯罪。在6年的随访期内，转回监狱的人数很少。近三分之一的患者出院至安全级别较低的环境。长期患者通常表现出更多的人格障碍、更高的精神病态特征和更高的风险评分，并且在治疗期间更频繁地受到强制措施。
结论
弗拉芒FPC人群的特点是性犯罪者比例高以及人格障碍患者比例高。正是最后这一组以及具有较高精神病态特征的组，停留时间比预期更长且难以重新融入社会。本研究进一步强调了在弗拉芒地区需要明确的标准来评估这些长期患者的状况。
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