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Mortality, Rehospitalisation and Violent Crime in Forensic Psychiatric Patients Discharged from Hospital: Rates and Risk Factors
Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom.
Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom.
Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, United Kingdom.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-6851-3297
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 5, e0155906Article in journal (Refereed) Published
Abstract [en]

Objectives: To determine rates and risk factors for adverse outcomes in patients discharged from forensic psychiatric services.

Method: We conducted a historical cohort study of all 6,520 psychiatric patients discharged from forensic psychiatric hospitals between 1973 and 2009 in Sweden. We calculated hazard ratios for mortality, rehospitalisation, and violent crime using Cox regression to investigate the effect of different psychiatric diagnoses and two comorbidities (personality or substance use disorder) on outcomes.

Results: Over mean follow-up of 15.6 years, 30% of patients died (n = 1,949) after discharge with an average age at death of 52 years. Over two-thirds were rehospitalised (n = 4,472, 69%), and 40% violently offended after discharge (n = 2,613) with a mean time to violent crime of 4.2 years. The association between psychiatric diagnosis and outcome varied-substance use disorder as a primary diagnosis was associated with highest risk of mortality and rehospitalisation, and personality disorder was linked with the highest risk of violent offending. Furthermore comorbid substance use disorder typically increased risk of adverse outcomes.

Conclusion: Violent offending, premature mortality and rehospitalisation are prevalent in patients discharged from forensic psychiatric hospitals. Individualised treatment plans for such patients should take into account primary and comorbid psychiatric diagnoses.

Place, publisher, year, edition, pages
San Francisco, USA: Public Library of Science , 2016. Vol. 11, no 5, e0155906
National Category
Medical and Health Sciences Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-54633DOI: 10.1371/journal.pone.0155906ISI: 000376291100130PubMedID: 27196309Scopus ID: 2-s2.0-84973616537OAI: oai:DiVA.org:oru-54633DiVA: diva2:1064483
Funder
Wellcome trustSwedish Research Council
Available from: 2017-01-12 Created: 2017-01-12 Last updated: 2017-01-26Bibliographically approved

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CiteExportLink to record
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Citation style
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