背景:在加拿大,确保公共安全,省审查委员会管辖下的被告的安全和福祉非常重要。虽然先前的研究报告了在法医精神病学环境中自我伤害行为(非自杀性自我伤害和自杀未遂)的重大风险,没有大规模人群研究评估法医系统相关因素与自残行为之间的任何关系.更好地了解这些因素可以帮助临床医生实施保护措施,以减轻自我伤害的行为或行动。
方法:使用安大略省审查委员会(ORB)数据库涵盖2014-2015年期间(n=1211,平均年龄=42.5±13.37岁,男性=86.1%),我们分析了与自我伤害行为相关的患病率和因素,强调法医系统相关因素的表征(ORB状态,法律地位,类型的进攻,以前的犯罪史,和受害者关系)。使用五个独立的逻辑回归模型探讨了法医系统相关因素与自残行为之间的关系,控制临床和社会人口统计学特征。
结果:在研究期间,法医系统中约有4%的人从事自我伤害行为。被确定为不适合接受试验的个体和住院患者更有可能出现自残行为.犯罪类型之间没有重大关系,受害者关系,和以前有自残行为的犯罪史。
结论:法医精神科住院患者应密切观察,筛选,监测,以及针对自我伤害行为的个性化管理策略。这项研究的结果表明,法医系统相关因素,尤其是那些与法医系统中个人地位有关的人(即,不适合受审和住院)对安大略省法医患者的自残行为负有更大的责任。
In Canada, ensuring public safety, and the safety and well-being of accused individuals under the jurisdiction of the provincial review board are very important. While previous studies have reported a significant risk of self-harming behaviors (non-suicidal self-injury and suicide attempt) in forensic psychiatric settings, no large population study has assessed any relationship between forensic system-related factors and self-harming behaviors. A better understanding of these factors can help clinicians implement protective measures to mitigate self-harming behaviors or actions.
Using the Ontario Review Board (ORB) database covering 2014-2015 period (n = 1211, mean age = 42.5 ± 13.37 years, males = 86.1%), we analyzed the prevalence and factors associated with self-harming behaviors, emphasizing the characterization of the forensic system-related factors (ORB status, legal status, type of offense, previous criminal history, and victim relationship). The relationships between the forensic system-related factors and self-harming behaviors were explored using five separate logistic regression models, controlling for clinical and sociodemographic characteristics.
Approximately 4% of the individuals in the forensic system over the study period engaged in self-harming behaviors Among the studied patients, individuals determined to be unfit to stand trial and inpatients were significantly more likely to have self-harming behaviors. There was no significant relationship between the type of offence, victim relationship, and previous criminal history with self-harming behavior.
Forensic psychiatry inpatients should have close observation, screening, monitoring, and individual tailored management strategies for self-harming behaviors. The findings of this study indicate that forensic system-related factors, especially those that pertain to the status of individuals in the forensic system (i.e., unfit to stand trial and being an inpatient) are more responsible for self-harming behaviors among forensic patients in Ontario.