Predictors of the discharge mode from forensic addiction treatment: Review of the determinants of success of a treatment order according to sec. 64 of the German Criminal Code (Part I)

Abstract

Before a forensic addiction treatment can be ordered by court according to sec. 64 of the German Criminal Code (StGB), a success prognosis must be made and affirmed. The search for appropriate predictors for a "sufficiently concrete prospect of success" was the focus of several studies in recent years. In addition to legal probation, the mode of release from the measure, i.e. whether regular release on probation or an end of the accommodation due to a lack of prospect of success, represents the central success criterion of forensic addiction treatment. As the first part of a two-part overview of the determinants of success in forensic addiction treatment, the aim of this paper was to provide an overview of the current state of knowledge on predictors of the discharge mode, both univariate and multivariate. Based on a systematic literature search, the results of 16 empirical studies from the period 1999 to 2019 are summarized and presented in detail. Univariate findings on individual predictors are presented in an overview table, while multivariate results are summarized in "typical" treatment discontinuations. On a univariate level, the findings were predominantly heterogeneous. The factors personality disorder and psychopathy as well as "static" anamnestic factors such as criminal background could be considered as reasonably reliable predictors. Multivariate, in particular the combination of an early onset of delinquency, a problematic social and/or occupational or educational background together with certain personality components, indicated a very high risk of premature discharge. The current state of research cannot provide an exhaustive answer to the question of decisive determinants of success or failure of a treatment acc. to sec. 64 StGB - measured by the discharge mode. However, the overview can assist forensic psychiatric experts in making a reliable prognosis of treatment prospects.