title: Decreased risk for violence in patients admitted to forensic care, measured with the HCR-20.
abstract: OBJECTIVE
  The aim of this study was to explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the clinical (C) and risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.
  
  
  METHODS
  The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.
  
  
  RESULTS
  The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.
  
  
  CONCLUSIONS
  The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.
authors.affiliation: Mid Sweden University, Sweden. helen.olsson@miun.se
authors.forename: Helen
authors.initials: H
authors.lastname: Olsson
authors.forename: Susanne
authors.initials: S
authors.lastname: Strand
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Kristiansen
authors.forename: Mats
authors.initials: M
authors.lastname: Sjöling
authors.forename: Kenneth
authors.initials: K
authors.lastname: Asplund
mesh_terms: D000293:Adolescent; D000328:Adult; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000451:nursing / Q000523:psychology; D003134:Commitment of Persons with Psychiatric Disorders; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D008875:Middle Aged; D010343:Patient Admission; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000175:diagnosis / Q000451:nursing / Q000523:psychology; D011329:Prisoners / Q000523:psychology*; D011594:Psychometrics / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000451:nursing / Q000523:psychology; D015203:Reproducibility of Results; D018570:Risk Assessment; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000451:nursing / Q000523:psychology; D013548:Sweden; D014754:Violence / Q000517:prevention & control / Q000523:psychology*; D055815:Young Adult