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Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

The authors of this publication include Michele Schmitter (IDA alumna) and Stefan Bogaerts (IDA staff).


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.

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

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. 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.

Schmitter, M., Vermunt, J., Blaauw, E., & Bogaerts, S. (2021). Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers. The Journal of Forensic Practice. 23(1), 39-52.

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