Páv Marek, Pekara Jaroslav, Valeš Jáchym, Závora Jiří, Korený Dominik, Zahrádka-Köhlerová Michaela, Anders Martin, Kitzlerová Eva
Department of Psychiatry, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czechia.
Department of Psychiatry, Bohnice Psychiatric Hospital, Prague, Czechia.
Front Psychiatry. 2025 Oct 23;16:1604957. doi: 10.3389/fpsyt.2025.1604957. eCollection 2025.
Limited research has explored the sociodemographic profiles, institutional behaviours, and treatment needs of women receiving forensic psychiatric care, particularly in Eastern Europe. Existing evidence suggests that women differ from men in several clinically significant ways that impact service delivery, treatment strategies, and overall care.
A cross-sectional design was employed involving 85 women and 753 men across 14 forensic psychiatric facilities in the Czech Republic. Data were collected at two-time points, six months apart, using the Health of the Nation Outcome Scale-Secure (HoNOS-secure) and the Modified Overt Aggression Scale (MOAS). Gender differences in psychiatric diagnoses, length of stay (LoS), aggression, and unmet needs were statistically analysed.
The mean age of women was 45.08 years, compared to 41.43 years for men. Women had a significantly shorter average LoS (893.27 days; SD 116-3935) than men (1358.36 days; SD 28-15311). Women were more often diagnosed with psychotic and substance use disorders, had higher rates of violent index offences, and were 2.33 times more likely to receive antipsychotic medications. Although women initially demonstrated higher MOAS scores, they showed significant improvement over time. Both genders exhibited reduced security needs at follow-up. Nonetheless, high levels of unmet needs remained, particularly among women.
The findings emphasise the importance of gender-responsive approaches in forensic psychiatric care. Establishing specialised forensic units for women is crucial to addressing their distinct clinical and psychosocial needs, enhancing treatment outcomes, and reducing recidivism. This study identifies critical service delivery gaps and reinforces the need to develop targeted interventions tailored to women in forensic settings.
针对接受法医精神病护理的女性的社会人口学特征、机构行为和治疗需求的研究有限，尤其是在东欧。现有证据表明，女性在几个对临床有重要意义的方面与男性不同，这些方面会影响服务提供、治疗策略和整体护理。
采用横断面设计，涉及捷克共和国14个法医精神病设施中的85名女性和753名男性。在相隔六个月的两个时间点收集数据，使用国民健康结果量表 - 安全版（HoNOS - secure）和改良外显攻击量表（MOAS）。对精神病诊断、住院时间（LoS）、攻击行为和未满足需求方面的性别差异进行了统计分析。
女性的平均年龄为45.08岁，男性为41.43岁。女性的平均住院时间（893.27天；标准差116 - 3935）明显短于男性（1358.36天；标准差28 - 15311）。女性更常被诊断患有精神病和物质使用障碍，暴力指数犯罪率更高，接受抗精神病药物治疗的可能性是男性的2.33倍。尽管女性最初的MOAS得分较高，但随着时间推移有显著改善。在随访中，两性的安全需求都有所降低。尽管如此，未满足需求的水平仍然很高，尤其是在女性中。
研究结果强调了在法医精神病护理中采用性别敏感方法的重要性。为女性建立专门的法医病房对于满足她们独特的临床和心理社会需求、提高治疗效果以及减少再犯至关重要。本研究确定了关键的服务提供差距，并强化了针对法医环境中女性制定有针对性干预措施的必要性。
