title: Neuropsychological Impairment and Its Association with Violence Risk in Japanese Forensic Psychiatric Patients: A Case-Control Study.
abstract: BACKGROUND
  In Japan, the legislation directing treatment of offenders with psychiatric disorders was enacted in 2005. Neuropsychological impairment is highly related to functional outcomes in patients with psychiatric disorders, and several studies have suggested an association between neuropsychological impairment and violent behaviors. However, there have been no studies of neuropsychological impairment in forensic patients covered by the Japanese legislation. This study is designed to examine the neuropsychological characteristics of forensic patients in comparison to healthy controls and to assess the relationship between neuropsychological impairment and violence risk.
  
  
  METHODS
  Seventy-one forensic patients with psychiatric disorders and 54 healthy controls (matched by age, gender, and education) were enrolled. The CogState Battery (CSB) consisting of eight cognitive domains, the Iowa Gambling Task (IGT) to test emotion-based decision making, and psychological measures of violence risk including psychopathy were used.
  
  
  RESULTS
  Forensic patients exhibited poorer performances on all CSB subtests and the IGT than controls. For each group, partial correlational analyses indicated that poor IGT performance was related to psychopathy, especially antisocial behavior. In forensic patients, the CSB composite score was associated with risk factors for future violent behavior, including stress and noncompliance with remediation attempts.
  
  
  CONCLUSIONS
  Forensic patients with psychiatric disorders exhibit a wide range of neuropsychological impairments, and these findings suggest that neuropsychological impairment may increase the risk of violent behavior. Therefore, the treatment of neuropsychological impairment in forensic patients with psychiatric disorders is necessary to improve functional outcomes as well as to prevent violence.
authors.affiliation: Division of Clinical Neuroscience, Center for Forensic Mental Health, Chiba University, Chiba, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nishinaka
authors.affiliation: National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakane
authors.affiliation: Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Nagata
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imai
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.
authors.forename: Noriomi
authors.initials: N
authors.lastname: Kuroki
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Sakikawa
authors.affiliation: Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Omori
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kuroda
authors.affiliation: Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Hirabayashi
authors.affiliation: Division of Law and Psychiatry, Center for Forensic Mental Health, Chiba University, Chiba, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Igarashi
authors.affiliation: Division of Clinical Neuroscience, Center for Forensic Mental Health, Chiba University, Chiba, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000987:Antisocial Personality Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D005555:Forensic Psychiatry / Q000331:legislation & jurisprudence / Q000379:methods*; D005715:Gambling / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D000066550:Physical Abuse / Q000517:prevention & control* / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents
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