engleski

Trends in forensic patients in a Department for Forensic Psychiatry of the University Hospital Vrapče in the last 50 years

University Hospital Vrapče is the oldest psychiatric hospital in Croatia and from the early days it was a place where not just civil patients were treated, but also forensic patients. Today it represents one quarter of all the forensic patients in Croatia. During the last fifty years (since the formal organization of the Department for Forensic Psychiatry, more than 400 forensic patients were treated in the institution. Today, forensic patients in Croatia are only those who were found not guilty for the reason of insanity and accessed as having a high risk of committing a new crime and therefore sent by the court to inpatient treatment. We present the trends in characteristics of these patients in the last fifty years that are influenced by changes in laws, widening of treatment possibilities (both pharmacotherapy and psycho- and sociotherapy). The most evident trend is the shortening of the forensic hospital treatment (from the mean of more than 100 months three decades ago to the mean of 36 months in the latest decade) and more forensic patients being already psychiatrically treated before the crime and later commitment of less violent crimes in recent patients, compared to those treated decades ago. There is also a slight trend of patients committing crimes at later age. Last few years also show a significant drop of new patients sent to forensic inpatient treatment. In the last two decades more patients were assessed by individual court experts (compared to institutional assessment) than forty years ago (45% compared to 20%). The gender ratio during these decades is constant (16% of women), with male patients being more often diagnosed with psychoactive substance related diagnoses and gender differences in marital status, but interestingly no differences in type of crimes, adherence to treatment and re-offending.

forensic psychiatry, not guilty for the reason of insanity

nije evidentirano