Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers. Issue 1 (2nd February 2021)

• Record Type: Journal Article
• Authors: Schmitter, Michele; Vermunt, Jeroen; Blaauw, Eric; Bogaerts, Stefan
• Is Part Of: Journal of forensic practice. Volume 23:Issue 1(2021)
• Page Start: 39
• Page End: 52
• Publication Date: 2021-02-02
• Subjects: Dual diagnosis; Forensic psychiatry -- Periodicals; Forensic psychology -- Periodicals; 614.15
• DOI: 10.1108/JFP-08-2020-0036
• Languages: English
• ISSNs: 2050-8794

Abstract

Abstract : Purpose: Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach: Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings: Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications: This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value: This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.