Purpose

Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers.

Design/methodology/approach

Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence).

Findings

Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption.

Practical implications

This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence.

Originality/value

This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.

中文翻译：

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在荷兰法医精神病学中心诊断出患有药物滥用疾病的患者的风险类别

目的

鉴于法医患者的药物滥用障碍（SUD），合并症的心理健康问题和犯罪再犯之间的复杂联系，同质的患者类别可以为精细治疗做出贡献。本文旨在构建被诊断为SUD的法医患者（N = 286）中的这些类别，这些法医患者是2004年至2013年间荷兰十个法医精神病学中心之一无条件释放的。

设计/方法/方法

回顾性数据来自电子患者档案。分类基于荷兰的风险评估工具Historisch Klinisch Toekomst-Revisie（历史临床未来修订版[HKT-R]），并通过潜在金版5.1版的探索性潜在类别分析进行识别。通过三步法，后班成员关系与外部变量（即诊断，毒品类型和犯罪类型）相关。

发现

确定了四个类别，分别具有不同的累犯风险以及Axis I和Axis II诊断以及药物消费类型。

实际影响

这项研究介绍了法医SUD患者的异质性，并确定了在治疗方法的重要变量方面不同的四个同质类别。基于这些类别，可以开发出更精细的治疗方法。讨论了可能的治疗方法，但需要进一步的研究来提供证据。

创意/价值

这项研究是第一个在法医SUD患者中识别类别的研究，因此，这是迈出第一步，根据可提供治疗信息的特征开发量身定制的治疗方法。