Clinicopsychopathological and mathematicalstatistical substantiation of risk assessment of dangerous acts committed by the mentally ill
Suggested citation:
Makushkina OA, Muganceva LA, Yakhimovich LA. [Clinicopsychopathological and mathematicalstatistical substantiation of risk assessment of dangerous acts committed by the mentally ill]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2016;(2):20-30. Russian
Presented are the results of a study to determine the potential social danger of patients with severe mental disorders. The proposed method of assessing the risk of dangerous behaviour is based on a complex of clinicalpsychopathological and mathematicalstatistical methods that define the informative value and prognostic coefficients of risk factors for dangerous acts by mentally disordered persons. Models of evaluation tools were developed with use of this method. Risk factors with a great information value are : conduct disorders in children and adolescents; explosive, excitable, aggressive, antisocial personality patterns in premorbid status; endured exogenousorganic hazards; low level of education; unsettled family life and substandard living conditions; alcohol and substance dependence ; unlawful conduct in past medical history; unemployment; patient noncompliance; also clinical and psychopathological features of psychiatric disorders: severe behavioral disorders, dissociality; altered emotional state, paradoxicality, distortion of moral and ethical sense; chronic delusional and hallucinatorydelusional syndromes; pronounced progression of disease with significant impairment in cognitive and critical functions, emotional inadequacy. When assessing the risk of repeated dangerous behavior of particular relevance are: the frequency of committed dangerous acts , duration of disease and psychopathological syndrome at the time these acts are committed; violations of conduct while undergoing compulsory treatment and their duration; the patient’s level of education; employment; family and household situation and financial standing ; use of alcohol and psychoactive substances; premorbid personality; progression of the disease process and the severity of cognitive impairments, critical abilities, emotional sphere; resistance and commitment to therapy. The use of the above indicators may enable psychiatrists to gain insight into the extent of potential public danger posed by a particular patient, to make a decision about the need to apply compulsory medical measures, and other measures of prevention of dangerous behaviour; to create effective individual programs for psychosocial therapy and rehabilitation, comprehensive prevention of disadaptation states and commission of dangerous acts.
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DOI: http://dx.doi.org/10.24411/1560-957X-2016-1%25x
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