The aim of this study was to compare the baseline characteristics (demographic, psychiatric-psychopathological and legal) among Greek forensic patients found not guilty by reason of insanity. The first step of this approach being differentiating patients who committed a criminal offense during their first psychotic episode from the ones who did so later in the course of their illness. All patients were hospitalized in the Department of Forensic Psychiatry (DFP) of the Psychiatric Hospital of Thessaloniki (PHT) from January 2015 to January 2020 and were examined in order to be included in the study. The final research sample consisted of 78 patients (70 identifying themselves as males and 8 identifying themselves as females) aged 18 and older, 21 of whom committed a criminal offense during their first psychotic episode (FEP, N = 21) and 57 did so later on in the course of their illness (Course, N = 57). Data were collected from multiple sources and several psychometric tools were used (Mini International Neuropsychiatric Interview-M.I.N·I, Positive And Negative Syndrome Scale-PANSS, Addiction Severity Index-ASI, CAGE Questionnaire, Hostility and Direction of Hostility Questionnaire-HDHQ, Global Assessment of Functioning-GAF and Aggression Questionnaire). Comparing the two groups (FEP vs. Course) we found that patients in FEP were younger, had experienced stressful life events in the last 24 months, committed more serious violent crimes, and more frequently attempted suicide after the crime. Their victims were usually members of their family. The main psychometric disparities between the two groups were found in the “Hostility” score of the Aggression questionnaire, and the items “Criticism of Others” and “Paranoid Hostility” of the HDHQ questionnaire, where patients in FEP scored lower. Patients in FEP scored significantly higher in items P1 (delusions), P4 (excitement), P6 (suspiciousness/persecution) and P7 (hostility) of the PANSS scale. No statistically significant differences were found between the two groups regarding their evaluation with the CAGE, ASI or GAF questionnaires. When comparing the patients' present scores in PANSS scale, the patients in FEP had lower total scores in the Positive and the General Psychopathology subscales. Both groups showed significant improvement during hospitalization in all scales (PANSS & GAF), except for the Negative Subscale of the PANSS scale. Through logistic regression analysis, we found that patients in FEP were younger, more likely to have recently experienced stressful life events and more likely to have assaulted a member of their family. Patients with higher scores in the “Hostility” subscale of the Aggression questionnaire were found to remain at risk for committing a crime during the course of their illness. These findings underline the need to design and develop specialized mental health services in order to identify and treat patients involved in violent crime in a timely and effective manner addressing their multiple needs.

本研究的目的是比较因精神错乱而无罪的希腊法医患者的基线特征（人口统计学、精神病学-精神病理学和法律）。这种方法的第一步是将在第一次精神病发作期间犯下刑事罪行的患者与在病程后期犯下罪行的患者区分开来。所有患者均于 2015 年 1 月至 2020 年 1 月在塞萨洛尼基精神病医院 (PHT) 的法医精神病科 (DFP) 住院，并接受检查以纳入研究。最终的研究样本包括 78 名年龄在 18 岁及以上的患者（70 名自称男性，8 名自称女性），其中 21 名在首次精神病发作 (FEP,N  = 21) 和 57 在他们的病程后期这样做（当然，N = 57）。从多个来源收集数据并使用了几种心理测量工具（迷你国际神经精神病学访谈-MIN·I、阳性和阴性症状量表-PANSS、成瘾严重程度指数-ASI、CAGE问卷、敌意和敌意方向问卷-HDHQ、全球评估功能-GAF 和侵略问卷）。比较两组（FEP 与课程），我们发现 FEP 患者更年轻，在过去 24 个月内经历过压力性生活事件，犯下更严重的暴力犯罪，并且更频繁地在犯罪后企图自杀。他们的受害者通常是他们的家庭成员。两组之间的主要心理测量差异在侵略问卷的“敌意”分数中发现，以及 HDHQ 问卷的“批评他人”和“偏执敌意”项目，其中 FEP 患者得分较低。FEP 患者在 PANSS 量表的 P1（妄想）、P4（兴奋）、P6（怀疑/迫害）和 P7（敌意）项目中得分显着更高。两组在 CAGE、ASI 或 GAF 问卷评估方面没有发现统计学上的显着差异。当比较患者在 PANSS 量表中的当前分数时，FEP 中的患者在阳性和一般精神病理学分量表中的总分较低。除了 PANSS 量表的负分量表外，两组在住院期间的所有量表（PANSS 和 GAF）均显示出显着改善。通过逻辑回归分析，我们发现 FEP 的患者更年轻，更有可能最近经历了压力大的生活事件，更有可能袭击了他们的家庭成员。发现在侵略问卷的“敌意”分量表中得分较高的患者在患病过程中仍然有犯罪的风险。这些发现强调需要设计和开发专门的心理健康服务，以便及时有效地识别和治疗参与暴力犯罪的患者，满足他们的多种需求。