Instytut Psychiatrii i Neurologii, Klinika Psychiatrii Sądowej.
Uniwersytet Jagielloński Collegium Medicum, Katedra Psychiatrii, Zakład Psychologii Lekarskiej.
Psychiatr Pol. 2022 Dec 31;56(6):1391-1404. doi: 10.12740/PP/OnlineFirst/136472.
The aim of this study was to perform an analysis of the risk factors of long-term psychiatric detention, defined as a stay in forensic institution exceeding respectively 60 and 84 months, based on data obtained from 150 patients from medium secure forensic psychiatry unit. The discussion was preceded by an analysis of the available literature in this field. The sociodemographic factors, the course of the mental disorder, the characteristic of committed criminal acts, aggressive or self-destructive behavior and the clinical characteristic of the illness in the last 6 months of psychiatric detention were analyzed.
A pilot study was based on a retrospective analysis of data from medical records and psychiatric experts' opinions of a cross-sectional nature. Due to the variables' characteristic, the Student's t-tests, Spearman's correlation and the Kruskal-Wallis rank ANOVA were used.
Risk of long-term hospitalization significantly correlated with factors related to the course of the last 6 months of inpatient treatment, including the mental state of patients, the occurrence of aggressive behaviors and the response to pharmacological treatment. There was no significant effect of demographic factors or coexisting addiction to alcohol and psychoactive substances. The risk of long-term psychiatric detention increased with the duration of the illness. There were no correlations with the age of the patients at the time of admission nor number of detentions. The nature of the diagnosis was also not found to be a risk factor.
Our study is the first systematic attempt to assess the risk factors of long-term psychiatric detention in a group of patients of forensic psychiatry centers in Poland. We hope that the presented results will rise a discussion on the shape of psychiatric care in Poland and encourage further research in this area, as well as they will contribute to the optimization of the treatment process.
本研究旨在对 150 名来自中度安全法医精神病学病房的患者的数据进行分析，以确定长期精神病住院的危险因素，定义为在法医机构的停留时间分别超过 60 个月和 84 个月。讨论之前，对该领域的现有文献进行了分析。分析了社会人口因素、精神障碍的病程、犯罪行为的特征、攻击性或自伤行为以及精神病住院最后 6 个月的临床特征。
一项试点研究基于对病历数据的回顾性分析和横断面性质的精神病专家意见。由于变量的特征，使用了学生 t 检验、斯皮尔曼相关性和克鲁斯卡尔-沃利斯秩方差分析。
长期住院的风险与与住院治疗最后 6 个月期间患者精神状态、攻击性行为的发生以及药物治疗反应相关的因素显著相关。人口统计学因素或同时存在酒精和精神活性物质成瘾没有显著影响。精神病长期住院的风险随着疾病持续时间的增加而增加。与入院时患者的年龄或拘留次数均无相关性。诊断的性质也不是一个危险因素。
我们的研究是首次系统评估波兰法医精神病中心一组患者长期精神病住院的危险因素。我们希望所呈现的结果将引发关于波兰精神病护理模式的讨论，并鼓励该领域的进一步研究，并有助于优化治疗过程。
