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

Abstract

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. 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. 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. 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. 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.