[Clinical, diagnostic and forensic features of a REMS patient's sample]

Riv Psichiatr. 2020 Nov-Dec;55(6):15-19. doi: 10.1708/3504.34901.
[Article in Italian]

Abstract

Introduction: Residential Services for the Execution of Security Measures (REMS) are specialist psychiatric units for forensic patients created in 2015 after OPG (Italian Security Psychiatric Forensic Hospitals) have been closed.

Aims: to describe the clinical, diagnostic and forensic features of patients and evaluate the relevance of 3 elements: use of alcohol and substance, antisociality, cognitive disability. A further aim is the evaluation of the level of pre and post admission diagnostic concordance.

Methods: A specific database has been set for the purpose of the study, which collects data of patients admitted in 5 years of activity of the unit. Data have been analysed through a descriptive approach.

Results: 4 main clusters have been identified: Psychosis, Use of Alcohol/Substance Disorder, Personality Disorder, Cognitive Disability. Alcohol/substance use, antisociality, cognitive disability elements are relevant in the sample. Diagnostic concordance level pre- and post- admission is overall good, sometimes partial.

Conclusions: alcohol/substance use, antisociality and cognitive disability, often in comorbidity mode, represent core features in part of the sample. This finding emphasizes a complexity level which is linked to social and judicial aspects, in addition to the health component.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol-Related Disorders / epidemiology
  • Antisocial Personality Disorder / epidemiology*
  • Cognition Disorders / epidemiology*
  • Databases, Factual
  • Diagnosis, Dual (Psychiatry) / statistics & numerical data
  • Female
  • Forensic Psychiatry / legislation & jurisprudence
  • Health Facility Closure
  • Hospitals, Psychiatric
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Psychotic Disorders / epidemiology*
  • Residential Facilities* / legislation & jurisprudence
  • Residential Facilities* / organization & administration
  • Retrospective Studies
  • Schizophrenia / epidemiology
  • Security Measures / legislation & jurisprudence*
  • Substance-Related Disorders / epidemiology*
  • Time Factors
  • Young Adult