title: A systematic review and synthesis of outcome domains for use within forensic services for people with intellectual disabilities.
abstract: BACKGROUND
  There is limited empirical information on service-level outcome domains and indicators for the large number of people with intellectual disabilities being treated in forensic psychiatric hospitals.
  
  
  OBJECTIVE
  This study identified and developed the domains that should be used to measure treatment outcomes for this population.
  
  
  METHODS
  A systematic review of the literature highlighted 60 studies which met eligibility criteria; they were synthesised using content analysis. The findings were refined within a consultation and consensus exercises with carers, patients and experts.
  
  
  RESULTS
  The final framework encompassed threea priorisuperordinate domains: (a) effectiveness, (b) patient safety and (c) patient and carer experience. Within each of these, further sub-domains emerged from our systematic review and consultation exercises. These included severity of clinical symptoms, offending behaviours, reactive and restrictive interventions, quality of life and patient satisfaction.
  
  
  CONCLUSIONS
  To index recovery, services need to measure treatment outcomes using this framework.
  
  
  BACKGROUND
  None.
  © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.
authors.affiliation: , PhD, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, and Complex and Forensic Service, Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK.
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authors.affiliation: , MRes, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
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authors.affiliation: , FRCPsych, Department of Psychiatry, Partnerships in Care, Department of Psychiatry, Leicestershire Partnership NHS Trust, and Department of Psychiatry, University of Leicester, Leicester, UK.
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