{"title":"接受精神健康障碍门诊治疗的法医精神病患者的再犯-一项荟萃分析。","authors":"Panagiota Bali, Fotios Chatzinikolaou, Evangelia Karachaliou, Jakub Lickiewicz, Tella Lantta, Konstantinos Tasios, Vasiliki Efstathiou, Athanasios Douzenis","doi":"10.1016/j.ijlp.2025.102155","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The risk for general or criminal recidivism in forensic psychiatric patients has not been extensively investigated in the literature. The aim of this review is to evaluate criminal recidivism among forensic patients with mental disorders undergoing some type of outpatient treatment.</p><p><strong>Methods: </strong>In this review, we utilized PubMed, Embase, Scopus, and the Cochrane Library to search for studies published from January 1990 up to July 2024. Eligible studies should i) evaluate forensic patients with mental health conditions, ii) evaluate patients undergoing outpatient treatment, and iii) evaluate criminal recidivism (general, sexual, or violent) as a primary outcome. Recidivism was also compared between groups when reported.</p><p><strong>Results: </strong>Overall, 12 clinical studies including 3271 patients were evaluated. Of these, 3048 patients undergoing outpatient treatment were analyzed. The mean age of all patients was 23.4 years (SD = 6.3), and 79.7 %. were male. The mean follow-up was 33.82 months. Overall, the pooled proportion for general recidivism was 39.1 % (95 % CI: 25 %-54.3 %), and for violent recidivism was 21.7 % (95 % CI: 2.6 %-52.3 %; data from four studies). In group comparisons (data from five studies), there was no difference between patients under treatment and the control groups as far as general recidivism (OR = 0.489; 95 % CI [0.202-1.183]; P = 0.112), and violent recidivism (OR = 0.283; 95 % CI [0.056-1.416]; P = 0.124) were concerned.</p><p><strong>Conclusion: </strong>The general and violent recidivism rates are high among forensic patients undergoing outpatient treatment for mental health disorders. There was no difference between outpatient treatment and control groups regarding their effect on recidivism. However, most of the studies reviewed did not provide information about drug treatment; more comparative studies focusing on pharmacotherapy are needed to verify any benefits of outpatient treatment.</p>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"104 ","pages":"102155"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Recidivism among forensic psychiatric patients undergoing outpatient treatment for mental health disorders - A meta-analysis.\",\"authors\":\"Panagiota Bali, Fotios Chatzinikolaou, Evangelia Karachaliou, Jakub Lickiewicz, Tella Lantta, Konstantinos Tasios, Vasiliki Efstathiou, Athanasios Douzenis\",\"doi\":\"10.1016/j.ijlp.2025.102155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The risk for general or criminal recidivism in forensic psychiatric patients has not been extensively investigated in the literature. The aim of this review is to evaluate criminal recidivism among forensic patients with mental disorders undergoing some type of outpatient treatment.</p><p><strong>Methods: </strong>In this review, we utilized PubMed, Embase, Scopus, and the Cochrane Library to search for studies published from January 1990 up to July 2024. Eligible studies should i) evaluate forensic patients with mental health conditions, ii) evaluate patients undergoing outpatient treatment, and iii) evaluate criminal recidivism (general, sexual, or violent) as a primary outcome. Recidivism was also compared between groups when reported.</p><p><strong>Results: </strong>Overall, 12 clinical studies including 3271 patients were evaluated. Of these, 3048 patients undergoing outpatient treatment were analyzed. The mean age of all patients was 23.4 years (SD = 6.3), and 79.7 %. were male. The mean follow-up was 33.82 months. Overall, the pooled proportion for general recidivism was 39.1 % (95 % CI: 25 %-54.3 %), and for violent recidivism was 21.7 % (95 % CI: 2.6 %-52.3 %; data from four studies). In group comparisons (data from five studies), there was no difference between patients under treatment and the control groups as far as general recidivism (OR = 0.489; 95 % CI [0.202-1.183]; P = 0.112), and violent recidivism (OR = 0.283; 95 % CI [0.056-1.416]; P = 0.124) were concerned.</p><p><strong>Conclusion: </strong>The general and violent recidivism rates are high among forensic patients undergoing outpatient treatment for mental health disorders. There was no difference between outpatient treatment and control groups regarding their effect on recidivism. However, most of the studies reviewed did not provide information about drug treatment; more comparative studies focusing on pharmacotherapy are needed to verify any benefits of outpatient treatment.</p>\",\"PeriodicalId\":47930,\"journal\":{\"name\":\"International Journal of Law and Psychiatry\",\"volume\":\"104 \",\"pages\":\"102155\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Law and Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ijlp.2025.102155\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"LAW\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Law and Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijlp.2025.102155","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"LAW","Score":null,"Total":0}
引用次数: 0
摘要
文献中还没有对法医精神病患者的一般或刑事累犯风险进行广泛的调查。本综述的目的是评估在接受某种类型门诊治疗的精神障碍法医患者的犯罪累犯情况。方法：在本综述中，我们使用PubMed、Embase、Scopus和Cochrane Library检索1990年1月至2024年7月间发表的研究。符合条件的研究应i)评估有精神健康状况的法医患者，ii)评估接受门诊治疗的患者，以及iii)评估刑事累犯（一般、性或暴力）作为主要结果。在报告时，还比较了两组之间的累犯情况。结果：总共评估了12项临床研究，包括3271例患者。其中，3048例接受门诊治疗的患者被分析。所有患者的平均年龄为23.4岁（SD = 6.3），占79.7%。是男性。平均随访时间为33.82个月。总的来说，一般累犯的总比例为39.1% (95% CI: 25% - 54.3%)，暴力累犯的总比例为21.7% （95% CI: 2.6% - 52.3%；数据来自四项研究）。组间比较（数据来自5项研究），治疗组与对照组在一般累犯（OR = 0.489; 95% CI [0.202 ~ 1.183]; P = 0.112）和暴力累犯（OR = 0.283; 95% CI [0.056 ~ 1.416]; P = 0.124）方面无差异。结论：在门诊接受精神障碍治疗的法医患者中，一般再犯率和暴力再犯率较高。门诊治疗组与对照组对再犯的影响无差异。然而，大多数研究没有提供有关药物治疗的信息；需要对药物治疗进行更多的比较研究，以验证门诊治疗的任何益处。
Recidivism among forensic psychiatric patients undergoing outpatient treatment for mental health disorders - A meta-analysis.
Introduction: The risk for general or criminal recidivism in forensic psychiatric patients has not been extensively investigated in the literature. The aim of this review is to evaluate criminal recidivism among forensic patients with mental disorders undergoing some type of outpatient treatment.
Methods: In this review, we utilized PubMed, Embase, Scopus, and the Cochrane Library to search for studies published from January 1990 up to July 2024. Eligible studies should i) evaluate forensic patients with mental health conditions, ii) evaluate patients undergoing outpatient treatment, and iii) evaluate criminal recidivism (general, sexual, or violent) as a primary outcome. Recidivism was also compared between groups when reported.
Results: Overall, 12 clinical studies including 3271 patients were evaluated. Of these, 3048 patients undergoing outpatient treatment were analyzed. The mean age of all patients was 23.4 years (SD = 6.3), and 79.7 %. were male. The mean follow-up was 33.82 months. Overall, the pooled proportion for general recidivism was 39.1 % (95 % CI: 25 %-54.3 %), and for violent recidivism was 21.7 % (95 % CI: 2.6 %-52.3 %; data from four studies). In group comparisons (data from five studies), there was no difference between patients under treatment and the control groups as far as general recidivism (OR = 0.489; 95 % CI [0.202-1.183]; P = 0.112), and violent recidivism (OR = 0.283; 95 % CI [0.056-1.416]; P = 0.124) were concerned.
Conclusion: The general and violent recidivism rates are high among forensic patients undergoing outpatient treatment for mental health disorders. There was no difference between outpatient treatment and control groups regarding their effect on recidivism. However, most of the studies reviewed did not provide information about drug treatment; more comparative studies focusing on pharmacotherapy are needed to verify any benefits of outpatient treatment.
期刊介绍：
The International Journal of Law and Psychiatry is intended to provide a multi-disciplinary forum for the exchange of ideas and information among professionals concerned with the interface of law and psychiatry. There is a growing awareness of the need for exploring the fundamental goals of both the legal and psychiatric systems and the social implications of their interaction. The journal seeks to enhance understanding and cooperation in the field through the varied approaches represented, not only by law and psychiatry, but also by the social sciences and related disciplines.
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