Abstract：
Aggression and violence are common day to day problems in psychiatric settings. However, the optimal means of assessing that risk remains unclear. In the context of that uncertainty many tools have evolved, among which the HCR-20 is one of the most globally accepted, though many questions remain about its performance, how and when it should be deployed and how it can be most effectively used. In this 12 month follow up study of 210 forensic psychiatric inpatients with a diagnosis of a schizophrenia spectrum disorder we explored these issues. We found that the performance of the HCR-20v3, especially its Total score, performed well up to 6 months after it was rated but its performance deteriorated after that. Repeating the HCR-20v3 at 6 months stabilised the risk assessment and led to improved performance in the second months over and above the first rating. The HCR-20v3 was good at identifying those subjects at low risk of violence over 6 months of follow up in a forensic inpatient setting. The real-world implications of this study are that the HCR-20v3 is an effective means of identifying patient at low risk of violence, but it should be reassessed every 6 months.
摘要：
侵略和暴力是精神病环境中常见的日常问题。然而,评估该风险的最佳方法尚不清楚.在这种不确定性的背景下，许多工具已经进化出来，其中HCR-20是最被全球接受的，尽管它的性能仍然存在许多问题，如何以及何时应该部署它，以及如何最有效地使用它。在对210名诊断为精神分裂症谱系障碍的法医精神病住院患者进行的为期12个月的随访研究中，我们探讨了这些问题。我们发现HCR-20v3的性能，特别是它的总分，在评级后的6个月内表现良好，但此后其性能恶化。在6个月时重复HCR-20v3稳定了风险评估，并导致第二个月的性能改善，高于第一评级。HCR-20v3可以很好地识别在法医住院患者环境中6个月随访期间暴力风险较低的受试者。本研究的现实世界的含义是，HCR-20v3是识别低暴力风险患者的有效手段，但应该每6个月重新评估一次.
