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Mapping Systematic Reviews on Forensic Psychiatric Care : A Systematic Review Identifying Knowledge Gaps

Howner, Katarina ; Andiné, Peter ; Bertilsson, Göran ; Hultcrantz, Monica ; Lindström, Eva LU ; Mowafi, Frida ; Snellman, Alexandra and Hofvander, Björn LU (2018) In Frontiers in Psychiatry 9. p.452-452
Abstract

Background: Forensic psychiatric care treats mentally disordered offenders who suffer mainly from psychotic disorders, although comorbidities such as personality disorders, neurodevelopmental disorders, and substance abuse are common. A large proportion of these patients have committed violent crimes. Their care is involuntary, and their caregivers' mission is complex: not only to rehabilitate the patient, but also to consider their risk for reoffending and their risk to society. The objective of this overview of systematic reviews is to identify, appraise, and summarize the existing knowledge in forensic psychiatric care and identify knowledge gaps that require further research. Methods: We undertook a systematic literature search for... (More)

Background: Forensic psychiatric care treats mentally disordered offenders who suffer mainly from psychotic disorders, although comorbidities such as personality disorders, neurodevelopmental disorders, and substance abuse are common. A large proportion of these patients have committed violent crimes. Their care is involuntary, and their caregivers' mission is complex: not only to rehabilitate the patient, but also to consider their risk for reoffending and their risk to society. The objective of this overview of systematic reviews is to identify, appraise, and summarize the existing knowledge in forensic psychiatric care and identify knowledge gaps that require further research. Methods: We undertook a systematic literature search for systematic reviews in five defined domains considered important in daily clinical practice within the forensic psychiatric care: (1) diagnostic assessment and risk assessments; (2) pharmacological treatment; (3) psychological interventions; (4) psychosocial interventions, rehabilitation, and habilitation; and (5) restraint interventions. The target population was mentally disordered offenders (forensic psychiatric patients aged >15 years). Each abstract and full text review was assessed by two of the authors. Relevant reviews then were assessed for bias, and those with moderate or low risk of bias were included. Results: Of 38 systematic reviews meeting the inclusion criteria, only four had a moderate risk of bias. Two aimed to incorporate as many aspects of forensic psychiatric care as possible, one investigated non-pharmacological interventions to reduce aggression in forensic psychiatric care, and one focused on women with intellectual disabilities in forensic care. However, most of the primary studies included in these reviews had high risks of bias, and therefore, no conclusions could be drawn. All of our identified domains must be considered knowledge gaps. Conclusion: We could not answer any of our research questions within the five domains because of the high risk of bias in the primary studies in the included systematic reviews. There is an urgent need for more research on forensic psychiatric care since all of our studied domains were considered knowledge gaps.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
forensic psychiatric care, Mentally disordered offenders, risk assessment, pharmalogical treatment, psychological interventions, psychosocial interventions, restraint interventions
in
Frontiers in Psychiatry
volume
9
pages
452 - 452
publisher
Frontiers Media S. A.
external identifiers
  • pmid:30319459
  • scopus:85074661784
ISSN
1664-0640
DOI
10.3389/fpsyt.2018.00452
language
English
LU publication?
yes
id
55f8ae8b-fccf-4947-8734-206c476b255a
date added to LUP
2019-05-21 19:13:51
date last changed
2024-06-19 17:17:12
@article{55f8ae8b-fccf-4947-8734-206c476b255a,
  abstract     = {{<p>Background: Forensic psychiatric care treats mentally disordered offenders who suffer mainly from psychotic disorders, although comorbidities such as personality disorders, neurodevelopmental disorders, and substance abuse are common. A large proportion of these patients have committed violent crimes. Their care is involuntary, and their caregivers' mission is complex: not only to rehabilitate the patient, but also to consider their risk for reoffending and their risk to society. The objective of this overview of systematic reviews is to identify, appraise, and summarize the existing knowledge in forensic psychiatric care and identify knowledge gaps that require further research. Methods: We undertook a systematic literature search for systematic reviews in five defined domains considered important in daily clinical practice within the forensic psychiatric care: (1) diagnostic assessment and risk assessments; (2) pharmacological treatment; (3) psychological interventions; (4) psychosocial interventions, rehabilitation, and habilitation; and (5) restraint interventions. The target population was mentally disordered offenders (forensic psychiatric patients aged &gt;15 years). Each abstract and full text review was assessed by two of the authors. Relevant reviews then were assessed for bias, and those with moderate or low risk of bias were included. Results: Of 38 systematic reviews meeting the inclusion criteria, only four had a moderate risk of bias. Two aimed to incorporate as many aspects of forensic psychiatric care as possible, one investigated non-pharmacological interventions to reduce aggression in forensic psychiatric care, and one focused on women with intellectual disabilities in forensic care. However, most of the primary studies included in these reviews had high risks of bias, and therefore, no conclusions could be drawn. All of our identified domains must be considered knowledge gaps. Conclusion: We could not answer any of our research questions within the five domains because of the high risk of bias in the primary studies in the included systematic reviews. There is an urgent need for more research on forensic psychiatric care since all of our studied domains were considered knowledge gaps.</p>}},
  author       = {{Howner, Katarina and Andiné, Peter and Bertilsson, Göran and Hultcrantz, Monica and Lindström, Eva and Mowafi, Frida and Snellman, Alexandra and Hofvander, Björn}},
  issn         = {{1664-0640}},
  keywords     = {{forensic psychiatric care; Mentally disordered offenders; risk assessment; pharmalogical treatment; psychological interventions; psychosocial interventions; restraint interventions}},
  language     = {{eng}},
  pages        = {{452--452}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Psychiatry}},
  title        = {{Mapping Systematic Reviews on Forensic Psychiatric Care : A Systematic Review Identifying Knowledge Gaps}},
  url          = {{http://dx.doi.org/10.3389/fpsyt.2018.00452}},
  doi          = {{10.3389/fpsyt.2018.00452}},
  volume       = {{9}},
  year         = {{2018}},
}