[History of treatment of schizophrenic forensic patients prior to admission: a comparison with schizophrenic general psychiatric patients].
BACKGROUND
The number of schizophrenic patients admitted to forensic hospitals according to section 63 of the German Criminal Code has increased continuously over the past years. Prior to admission to a forensic ward, two thirds of schizophrenic patients have been admitted to a general psychiatric institution at least once. Among other factors, forensic admission is seen as a consequence of insufficient pretreatment in general psychiatry. This study aims to identify differences regarding the history of treatment of forensic and general psychiatric patients diagnosed with schizophrenia.


METHODS
The matched samples include 72 male patients from forensic wards and 72 male patients from general psychiatry diagnosed with schizophrenia. The history of psychiatric treatment was reconstructed by interviewing the patients as well as the outpatient psychiatrists and by analyzing these patients' medical records.


RESULTS
Both groups showed similar risk factors, however, forensic patients had a higher number of previous convictions and were convicted more often for violent offences. Furthermore, the data indicate that forensic patients are less integrated into psychiatric care and showed a lower rate of treatment compliance prior to admission to a forensic ward.


CONCLUSIONS
The results provide support for the arrangement of an intensive outpatient aftercare, especially for schizophrenic patients with comorbid substance abuse disorders and previous convictions for violent offences.
Institut für Forensische Psychiatrie, Universität Duisburg-Essen, Virchowstr. 174, 45147 Essen, Deutschland. kristina.piontek@lvr.de
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Kutscher
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König
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Leygraf
D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D015897:Comorbidity; D003415:Crime / Q000331:legislation & jurisprudence / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005858:Germany; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome; D014754:Violence / Q000331:legislation & jurisprudence / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult