Prevalence of the hospitalisation of mentally ill offenders in the Forensic Unit of the Clinic of Psychiatry in Pristina over a three-year period and long-term strategy implications for the management of the Forensic Mental Health System Service.
As a new field in our country, forensic psychiatry needs strategies for management and rehabilitation programmes.AimThe aim of this study was to evaluate the sociodemographic characteristics of psychiatrically diagnosed inpatients who were hospitalised in the three years from January 2009 to December 2011 and the prevalence of such diagnoses. The specific objectives of this study were to use our results to identify rehabilitation programmes for the treatment of patients and to identify the specific training needs of mental-health professionals.Methods
In this retrospective study, we collected data about the sociodemographics and violent behaviour of all forensic inpatients who underwent court-ordered psychiatric forensic evaluation and assessment. We reviewed and studied the documented diagnoses based on the following criteria and sources: the ICD-10 criteria for mental disorders, the Structured Clinical Interview (SCID), recidivism rates, criminal data, court records and other hetero-anamnesis data. The data were analysed using a descriptive approach.ResultsThe subjects were referred for forensic psychiatric evaluation, diagnosis and treatment either directly from prison (23.2%) or from the court (76.8%). The majority of the offenders (85.7%) were currently on trial, and charges of physically threatening others were more common than charges of domestic violence or murder. The prevalence of psychiatric diagnosis was 94.6%, and the most common diagnosis was psychosis (69.1%). Drug abuse and personality disorders, including high-risk behaviours, were also common. The overall relapse rate for aggressive behaviour was 48.9%.Conclusion
Rehabilitation programmes for treatment and management are needed that specifically focus on psychotic disorders, severe personality disorders and drug abuse.
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ABSTRACT: Purpose Media reports and the official statistics published after the war in Kosova demonstrate a rising trend of suicide in general population. In the past in our clinic have been little interest in whether suicidal risk and behavior has been documented and whether these signs of risk and suicide behavior is associated with Mental disorder and PTSD. Methods 134 offenders hospitalized in period time 2007–2009 were included. We used DSM-IV criteria, SBQ-R and assessed risk of suicide factors. Results 31,9% were diagnosed with personality disorder, 21,3% were psychotic, 8,5% were drug abusers, 21,3 were depressed with PTSD signs of trauma war, and 17% of them without diagnosis. Risk factors such are abnormal behavior, isolation, hopelessness, depression or other mental disorder, family problems or personal loss and drug or alcohol intoxication were important risk factors for suicidal behavior in 73% of them.12,8 % reported attempt of suicide, 14,9% of them reported that have had a plan to kill themselves, 40% reported that have told someone that are going to commit suicide, and 23,4% reported that they are likely to attempt suicide someday. Suicidal thoughts and attempts were commoner in forensic setting than in general population and were significantly associated with Personality disorder, Psychosis and PTSD. Conclusion Suicide behavior and its significant association with mental disorder play an important role and should include training programs in recognition of offenders at high risk behavior and preventive programme management in forensic settings in our country. Copyright © 2011 Elsevier Masson SAS. All rights reserved.European Psychiatry 01/2011; 26:1832-1832. DOI:10.1016/S0924-9338(11)73536-2 · 3.21 Impact Factor
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ABSTRACT: Problem Statement: Brief screening instruments for personality disorders could potentially have great value in community and clinical settings regarding early intervention, treatment methods and other psycho-social approaches. Research Questions: How are sensitive and useful the known brief instruments for personality disorders in identifying cases of these disorders in the community and in clinical cases. Purpose of the Study: Knowing the extent of certain dimensions and personality disorders in community and clinical settings based on the tools sensitivity for their screens. Research Methods: It’s a correlational study. One purposeful community sample (N=399 299 teachers of primary and secondary schools in Prishtina and 100 students of UET in Tirana) and one clinical sample (N=41 patients of one private clinic) filled out IIP-PD-25 questionnaire (Pilkonis et al. 1996). Their choice was random. All data has been analyzed by SPSS 21 and Excel 2007. Findings: PD index screen resulted with PD probably to definite score 29.2% of community sample vs. 43.9 % of clinical sample . Age (youngest) and residence (urban) showed significant negative correlation only for community sample. We don’t found statistically significant differences regarding levels of PD screen index based on gender and between community and clinical sample. Conclusions: Screening with the IIP-PD-25 gives the possibility to conclude a high presence of Personality Disorders in both our samples. Personality disorders often cause problems for others and are costly to society early screening, identification and treatment is highly valued public health topic to be addressed.The European Proceedings of Social & Behavioural Sciences eISSN: 2357-1330; 01/2015
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ABSTRACT: Mentally disordered offenders (MDOs) represent a complex and diverse population who are often regarded as difficult to treat. Accordingly, the practitioners who are tasked with their reintegration face many challenges which are compounded by a paucity of published research on interventions with MDOs and a lack of comprehensive rehabilitation models to orient their practice. This article provides an overview of published literature on interventions used in inpatient forensic mental health services over the past 15 years. The literature is categorized according to its broad theoretical orientation and three broad approaches are identified: (1) Treatments targeting mental illness and other psychological issues; (2) Interventions based on the principles of the Risk-Need-Responsivity (RNR) model that aim to reduce recidivism; and (3) Strength-based models. The literature review highlights a practice of blending divergent models in an attempt to cater to the wide-ranging needs of forensic patients. It is asserted that this practice, which is problematic for a number of reasons, is underpinned by an absence of overarching rehabilitation frameworks to integrate the multiple elements of forensic practice. It is proposed that the Good Lives Model of offender rehabilitation, when adapted for use in a forensic context, may provide a promising way forward.Aggression and Violent Behavior 04/2015; 22. DOI:10.1016/j.avb.2015.04.009 · 1.95 Impact Factor