title: Violent recidivism among mentally disordered offenders in Japan.
abstract: BACKGROUND
  A new forensic mental health law was enacted in Japan in 2003, enabling development of specialist services. Before their establishment, it is important to determine the nature, frequency and correlates of the problems they are designed to ameliorate.
  
  
  OBJECTIVE
  To establish rates of violent recidivism among mentally disordered offenders before the new legislation, and examine associated risk factors.
  
  
  METHODS
  Data were extracted from one complete annual (1980) national cohort of people judged by the Court or prosecutor to be without responsibility for a criminal offence, or of sufficiently diminished responsibility for it to be diverted for psychiatric treatment. The outcome measure was violent recidivism after community discharge and before 1991.
  
  
  RESULTS
  Fifty-two (10%) of 489 in the cohort were arrested or convicted of further violent offences. Violent recidivism was most strongly associated with a substance-related disorder, but histories of violence, homelessness and short index admissions were independently related.
  
  
  CONCLUSIONS
  Violent recidivism was so unusual that, on this outcome, it could take many years to show any effect of the new service. Desistance from substance use, compliance with treatment and maintenance of stable housing may be better indicators of success, and their achievement a good preventive strategy.
authors.affiliation: Department of Forensic Psychiatry, National Centre of Neurology and Psychiatry, Tokyo, Japan. yoshikaw@ncnp.go.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Taylor
authors.forename: Akira
authors.initials: A
authors.lastname: Yamagami
authors.forename: Takayuki
authors.initials: T
authors.lastname: Okada
authors.forename: Kumiko
authors.initials: K
authors.lastname: Ando
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Taruya
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Akiko
authors.initials: A
authors.lastname: Kikuchi
mesh_terms: D015331:Cohort Studies; D003415:Crime / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology*; D012008:Recurrence; D014754:Violence / Q000706:statistics & numerical data*