Comprehensive assessment of clinical, social and psychological factors affecting the duration of execution of compulsory measures of a medical nature

Abstract

The article presents the results of the study of patients, undergoing long-term compulsory treatment in a psychiatric hospital. It has been established that the factors, affecting the duration of treatment, include: frequent exacerbation of a mental disorder; persistent aggressive behaviour; lack of adherence to treatment; severe employment and family maladjustment, housing insecurity; the need for nursing care, and helplessness due to mental disorder in the absence of family ties. The main factors that increase the probability of aggression among patients are: young age at the time of committing socially dangerous actions, long history of aggressive behavior on the ward, and repeated violations of the regimen of the psychiatric hospital. For purposes of preventing public dangerousness of such patients, it is necessary to conduct sessions of psychologically correcting interventions, aimed at forming the defense mechanisms, that would impede the manifestation of aggressive intentions. Determining the potential public dangerousness of patients in the course of considering the issue of either cancelling or prolonging mandatory treatment, should be comprehensive and reliant on the multi-axial principle, with the systematization of risk factors for dangerous behavior on several grounds – clinical, personal, pathopsychological, and social adaptation.