4.2 Article

Individuals with schizophrenia who act violently towards others profit unequally from inpatient treatment-Identifying subgroups by latent class analysis

Publisher

WILEY
DOI: 10.1002/mpr.1856

Keywords

forensic psychiatry; Hodgins typology; latent class analysis; offenders with schizophrenia spectrum disorder; psychopathology; treatment effects

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Through latent class analysis, the study identified three subtypes of offenders with schizophrenia - early starters, late starters, and all-course starters, showing different levels of symptom remission during inpatient treatment. Tailored psychiatric treatment may be necessary to provide more equal benefits to offender patient subgroups.
Background People with schizophrenia show a higher risk of committing violent offenses. Previous studies indicate that there are at least three subtypes of offenders with schizophrenia. Objectives Employing latent class analysis, the goals of this study were to investigate the presence of homogeneous subgroups of offender patients in terms of remission in psychopathology during inpatient treatment and whether or not these are related to subtypes found in previous studies. Results should help identify patient subgroups benefitting insufficiently from forensic inpatient treatment and allow hypotheses on possibly more suitable therapy option for these patients. Methods A series of latent class analyses was used to explore extensive and detailed psychopathological reports of 370 offender patients with schizophrenia before and after inpatient treatment. Results A framework developed by Hodgins to identify subgroups of offenders suffering from schizophrenia is useful in predicting remission of psychopathology over psychiatric inpatient treatment. While early starters were most likely to experience remission of psychopathology over treatment, late late starters and a subgroup including patients from all three of Hodgins' subgroups in equal proportions benefited least. Negative symptoms generally seemed least likely to remit. Conclusion Psychiatric treatment may have to be more tailored to offender patient subgroups to allow them to benefit more equally.

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