Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

Michele Schmitter*, Jeroen Vermunt, Eric Blaauw, Stefan Bogaerts

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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.

Original languageEnglish
Pages (from-to)39-52
JournalJournal of Forensic Practice
Volume23
Issue number1
DOIs
Publication statusPublished - 2021

Keywords

  • Dual diagnosis

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