Risk evaluation of relapse into violent crime in offenders with mental disorders in two different rehabilitation programs: a case-control study

Introduction

Over the last years, many research groups have been working on evaluating the most appropriate rehabilitation approaches in offenders with mental disorders, taking into account the need to prevent crime reiteration. The HKT-R (Historisch Klinisch Toekomst- Revised), recently validated in Italy, is a comprehensive tool that offers useful indications to healthcare operators on relapse hazard and major risk areas on which intensify rehabilitation treatments. The present study aims to assess the risk of violent crime recidivism in psychiatric patients during different rehabilitative pats.

Materials&Methods

the risk of violent crime recidivism was assessed by using the HKT-R in 34 patients with mental disorders treated in ordinary psychiatric therapeutic rehabilitative units (CRAP - Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche) and in CRAP-D (Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche Dedicate) specialized in crime offenders.

Results and Conclusions

Results have demonstrated a higher risk of violent behavior in CRAP-D, and a negative correlation between the risk of violent recidivism, global functioning of patients, and length of care program. These data suggest that residential rehabilita-tion programs, by improving personal and social functioning, could negatively impact the risk of violent crime recidivism, especially in patients with severe mental illness.

The prescription of psychotropic drugs in psychiatric residential facilities: a national survey in Italy

OBJECTIVE

This paper reports the prescriptions of psychotropic drugs made to 2962 patients living in 265 residential facilities (RFs) in Italy.

METHOD

Structured interviews were administered to RF managers and staff to obtain data on patients' sociodemographic and clinical characteristics; information about current drug prescriptions were obtained from clinical records.

RESULTS

Polypharmacy was common: on average, each treated patient was taking 2.7 drugs (+/-1.1). The association of one atypical antipsychotic with one benzodiazepine represented the most common prescription profile. The variable most consistently associated with a higher likelihood of receiving polypharmacy was a history of admission to an acute general hospital psychiatric ward in the previous 12 months. Many prescriptions were loosely related to specific diagnoses.

CONCLUSION

Psychotropic drug prescription patterns for severe patients living in RFs are characterized by substantial rates of polypharmacy. Specific guidelines may be helpful for long-stay patients living in RFs, who exhibit complex care needs.