Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.
Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden.
Int J Law Psychiatry. 2023 May-Jun;88:101884. doi: 10.1016/j.ijlp.2023.101884. Epub 2023 Mar 27.
The aim of this study was to evaluate criminal outcomes of mentally disordered offenders in compulsory forensic psychiatric care during the year 2010 versus 2018. More specifically, we sought to identify the occurrence of new criminal sentences during ongoing treatment and possible factors associated with recidivistic criminality. Another aim was to map previous criminality, types of index crime, and whether there were any changes within this decade.
Crime-, clinical, and treatment-related variables were collected from the Swedish National Forensic Psychiatric Register for all unique inpatients registered from January 1-December 31 in 2010 (N = 717) and 2018 (N = 757). The mean, frequency, percentage, and standard deviation were calculated per variable and stratified by study year and gender. Between-group comparisons were made using t-tests and Chi-square tests. Binary logistic regression was performed to determine whether variables expected to be associated with recidivism showed any relation to criminal recidivism for each study cohort.
Most patients were male and approximately one-quarter and one-half of the men, respectively, had a previous sentence for non-violent and violent crimes. The 2018 cohort showed significantly lower rates of sentences to forensic psychiatry with special court supervision although the numbers were low in both cohorts and for both men and women. Previous violent conviction was associated with criminal recidivism during treatment in 2010, while this was joined by index crime under the influence of alcohol/illicit drugs for the 2018 cohort.
Overall, these results showed more similarities between the 2010 and 2018 cohorts then dissimilarities, while on the other hand some quite substantial differences were described between males versus females. The results of this study indicate that it may be possible to tailor forensic psychiatric treatment to gender as a proxy for other variables related to increased criminal recidivism in offenders sentenced to forensic psychiatric care.
本研究旨在评估 2010 年和 2018 年强制精神病司法管辖区内精神障碍罪犯的犯罪结果。更具体地说，我们试图确定在持续治疗过程中新的刑事判决的发生情况，以及与复发性犯罪相关的可能因素。另一个目的是绘制前犯罪情况、索引犯罪类型，并确定这十年内是否有任何变化。
从瑞典国家法医精神病学登记处收集了所有在 2010 年 1 月 1 日至 12 月 31 日（n=717）和 2018 年（n=757）期间登记的唯一住院患者的犯罪、临床和治疗相关变量。按变量计算平均值、频率、百分比和标准差，并按研究年份和性别进行分层。使用 t 检验和卡方检验进行组间比较。对二元逻辑回归进行了分析，以确定预期与复发相关的变量是否与每个研究队列的犯罪复发有关。
大多数患者为男性，大约四分之一和一半的男性分别因非暴力和暴力犯罪而被判有先前的判决。2018 年队列的特殊法院监督的法医精神病学判决率明显较低，尽管两个队列的人数都很少，而且男女比例都很低。2010 年，以前的暴力定罪与治疗期间的犯罪复发有关，而 2018 年，这一结果则由在酒精/非法药物影响下的索引犯罪所取代。
总的来说，这些结果显示出 2010 年和 2018 年队列之间的相似之处多于不同之处，而另一方面，男性与女性之间的差异相当大。本研究结果表明，根据与被判强制精神病司法管辖区的罪犯的犯罪复发相关的其他变量，有可能根据性别来调整法医精神病治疗。
