[Forensic addiction treatment in Germany (section 64 of the penal code): three therapeutically and predicatively relevant clusters of drinkers].
OBJECTIVE
According to section 64 of the German penal code, offenders may be sentenced to compulsory addiction treatment in forensic mental hospitals. An expert witness assesses each candidate regarding the prognosis of treatment. Frequently, optimistic assessments are not confirmed, and approximately half of the patients are returned to prison. The study aims at learning more about patients' characteristics relevant for treatment outcome by considering subgroups of patients.


METHODS
150 drinkers treated according to art. 64 were interviewed and psychologically assessed in an early stage of treatment. Therapists reported on treatment outcome. A cluster analysis was conducted.


RESULTS
Like in former research, 3 considerably differing subgroups of patients could be identified.


CONCLUSIONS
A "multi-problem" subgroup with early onset of severe behavior problems has a very small chance to profit from treatment. In this group of offenders, the prospects of a detention according to art. 64 of the penal code should be assessed very critically. On the other hand, efforts must be taken to refine treatment methods adequate for this high risk group.
Institut für Forensische Psychiatrie Essen. norbert.schalast@uni-duisburgessen.de
Norbert
N
Schalast
Cornelia
C
Kösters
Rita
R
Demmerling
Sylvia
S
Mushoff
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D000437:Alcoholism / Q000145:classification / Q000453:epidemiology / Q000534:rehabilitation*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D016000:Cluster Analysis; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D015897:Comorbidity; D003415:Crime / Q000331:legislation & jurisprudence / Q000523:psychology / Q000706:statistics & numerical data; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005858:Germany; D006801:Humans; D007406:Interview, Psychological; D007902:Length of Stay / Q000331:legislation & jurisprudence; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D010552:Personality Assessment / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers / Q000331:legislation & jurisprudence; D016896:Treatment Outcome; D014754:Violence / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data