Individuals with schizophrenia who act violently towards others profit unequally from inpatient treatment-Identifying subgroups by latent class analysis.

Abstract

BackgroundPeople with schizophrenia show a higher risk of committing violent offenses. Previous studies indicate that there are at least three subtypes of offenders with schizophrenia.ObjectivesEmploying latent class analysis, the goals of this study were to investigate the presence of homogeneous subgroups of offender patients in terms of remission in psychopathology during inpatient treatment and whether or not these are related to subtypes found in previous studies. Results should help identify patient subgroups benefitting insufficiently from forensic inpatient treatment and allow hypotheses on possibly more suitable therapy option for these patients.MethodsA series of latent class analyses was used to explore extensive and detailed psychopathological reports of 370 offender patients with schizophrenia before and after inpatient treatment.ResultsA framework developed by Hodgins to identify subgroups of offenders suffering from schizophrenia is useful in predicting remission of psychopathology over psychiatric inpatient treatment. While “early starters” were most likely to experience remission of psychopathology over treatment, “late late starters” and a subgroup including patients from all three of Hodgins' subgroups in equal proportions benefited least. Negative symptoms generally seemed least likely to remit.ConclusionPsychiatric treatment may have to be more tailored to offender patient subgroups to allow them to benefit more equally.