A register-based comparison study of Swedish patients in forensic psychiatric care 2010 and 2018

Alessio Degl' Innocenti; Eirini Alexiou; Peter Andiné; Jolita Striskaite; Thomas Nilsson

doi:10.1016/j.ijlp.2021.101715

A register-based comparison study of Swedish patients in forensic psychiatric care 2010 and 2018

Int J Law Psychiatry. 2021 Jul-Aug:77:101715. doi: 10.1016/j.ijlp.2021.101715. Epub 2021 May 28.

Authors

Alessio Degl' Innocenti¹, Eirini Alexiou², Peter Andiné³, Jolita Striskaite⁴, Thomas Nilsson³

Affiliations

¹ Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Gothia Forum for Clinical Research, Sahlgrenska University Hospital, Gothenburg, Sweden.
² Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: eirini.alexiou@vgregion.se.
³ Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden.
⁴ Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.

PMID: 34052684
DOI: 10.1016/j.ijlp.2021.101715

Abstract

Purpose: This study compared the characteristics of a population of Swedish patients in forensic psychiatric care in the year 2010 and 2018, with the goal of identifying similarities and differences in sociodemographic and clinical outcomes during the study period.

Findings: Significant changes in patient characteristics and treatment aspects were found, although similarities between the years were more common. Schizophrenia, schizotypal and delusional disorders were the most predominant primary diagnoses characterizing forensic psychiatric patients. From 2010 to 2018 there was also a development in care conditions supporting a shift from inpatient to outpatient care and from first-generation antipsychotic/neuroleptic to second-generation antipsychotics/atypical antipsychotics. More liberty restrictive such as physical restraints and forcible medication diminished while less restrictive coercive measures increased. There was also a decrease in the length of stay in forensic psychiatric care among those treated 2018 compared to those treated 2010, something that emerged as particularly discernible among male patients.

Conclusion: In conclusion, the results from this study illustrate the similarities among a Swedish forensic psychiatric population between the years of 2010 and 2018, while also reflecting some changes in patient characteristics and clinical practice during the study period.

Keywords: Clinical outcome; Compulsory care; Demographics; Forensic psychiatry; Pharmacotherapy; Treatment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antipsychotic Agents* / therapeutic use
Coercion
Humans
Male
Restraint, Physical
Schizophrenia* / diagnosis
Schizophrenia* / therapy
Sweden

Substances

Antipsychotic Agents