Trois profils cliniques à risque de comportements violents dans une cohorte de patients présentant un premier épisode de psychose

Moulin, Valérie; Alameda, Luis; Baumann, Philipp S.; Gholamrezaee, M.M.; Palix, Julie; Gasser, Jacques; Conus, Philippe

doi:10.1016/j.encep.2018.08.003

Cited by 4 publications

(1 citation statement)

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“…The latter is especially prevalent in combination with antisocial personality traits and impulsivity. The presence of SUDs can also predict violent offending and reoffending (31)(32)(33)(34) and are linked to antisocial traits and impulsivity (11). Violent offending and SUDs often go hand-in-hand as violent offenders are often intoxicated or under the influence of substances at the time of the offense (21,35,36).…”

Section: Introductionmentioning

confidence: 99%

Substance Use Disorders as a Critical Element for Decision-Making in Forensic Assertive Community Treatment: A Systematic Review

Marquant

Nuffel²,

Sabbe

et al. 2021

Front. Psychiatry

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Introduction: The prevalence of substance use disorders in forensic populations is high. They are an important factor linked to negative outcomes in mentally ill offenders and are detrimental to forensic or non-forensic outcome measures. In contrast, substance use disorders are often underdiagnosed and undertreated, especially in forensic settings. Forensic Assertive Community Treatment is a forensic adaptation of regular assertive community treatment, combined with essential elements of forensic rehabilitation theories. Little is known however on the effectivity of forensic assertive community treatment when it comes to substance use disorders or what their exact role is on the outcome measures. In this paper, we explore how SUD is treated in Forensic assertive community treatment and how it relates to the forensic and non-forensic outcome measures.Methods: We performed a systematic review (PRISMA) of forensic Assertive community treatment teams that followed the main evidence-based principles of regular assertive community treatment and added basic elements of forensic rehabilitation. We analyzed articles the Psychinfo and Medline databases dating from 2005 to 2020. Fifteen studies fit the search criteria and were included in the analysis. The Quality of the studies was assessed using the Newcastle-Ottawa scale.Results: SUD was highly prevalent in all studies. Patients entered FACT through two pathways, either from a care continuum or directly from prison. The severity of SUD at intake emerges as a critical element when deciding which pathway to choose, as a high severity-score at the start of FACT follow-up was linked to recidivism. While differing in method all studies offered integrated SUD treatment. These included evidence-based techniques like CBT, therapeutic communities, and Substance Abuse Management Module. Though results on SUD outcomes were mixed 4 studies mentioned abstinence in 50–75%. The severity of SUD tended to increase initially and to stabilize afterwards.Conclusion: Severity of SUD at intake emerges as a decisive element in decision-making on entering FACT teams directly from prison or through a care-continuum. The ways to provide SUD treatment varied and outcomes for SUD were mixed. SUD was found to be detrimental to forensic and non-forensic outcome measures, such as recidivism or hospitalizations during FACT treatment.

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