[Patient Groups with Different Risk Profiles for Irregular Drop-Out from Forensic Psychiatry (§ 64 StGB)].

OBJECTIVE About 50 - 70 % of the patients with substance abuse disorders who are mandated to forensic treatment according to the section 64 of the German penal code are discharged from treatment irregularly. Previous research identified a number of potential risk factors for irregular treatment dropout. Systematic assessment of risks factors and their consideration for treatment planning may help to improve treatment retention. Therefore, the aim of this study was to identify groups of patients with a comparable risk profile for treatment dropout. METHODS From 2007 - 2012, patients entering forensic treatment completed the MATE-Crimi and a sociodemographic questionnaire. RESULTS From 431 patients entering forensic treatment, 357 patients agreed to participate. Of the 357 included patients 35.9 % had completed the forensic treatment irregular. Using cox regression, young age, low treatment motivation and a primary criminal behaviour with the substance use as a consequence of criminal behaviour were identified as risk factors for early drop-out. A subsequent analysis of latent classes using these variables resulted in three classes. CONCLUSIONS Our study revealed a small number of risk factors being relevant for treatment drop-out. Furthermore, we identified three groups of patients with different risk profiles. Next steps include the development of treatment pathways for these patient groups.

[1]  J. Endrass,et al.  Indikatoren für den Verlauf einer stationären Behandlung bei Straftätern mit Substanzmittelabhängigkeit , 2011 .

[2]  A. Bezzel Können Patienten aus dem Maßregelvollzug (§ 64 StGB) resozialisiert werden? , 2010 .

[3]  K. Berger Erfassung von forensischen Patienten (§ 64 StGB) unter besonderer Berücksichtigung der Psychopathy Checklist nach Hare (PCL-R) , 2010 .

[4]  N. Schalast,et al.  Zur Prognose des Behandlungsverlaufs bei strafrechtlicher Unterbringung in der Entziehungsanstalt , 2009 .

[5]  T. Kallert,et al.  Zum Outcome der Maßregelvollzugsbehandlung nach § 64 StGB , 2007 .

[6]  T. Roß,et al.  Die Beurteilung von lebenspraktischen Fertigkeiten forensisch-psychiatrischer Patienten mit dem BEST-Index , 2007 .

[7]  W. van den Brink,et al.  Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres. , 2007, Addiction.

[8]  K. Hoffmann Strafrechtlich angeordnete Suchtbehandlung im Maßregelvollzug – Stiefkind der Suchttherapie oder fachliche Herausforderung? , 2007 .

[9]  Joachim Weimer Juristische Grundlagen der Unterbringung alkohol- und drogenabhängiger Straftäter in Entziehungsanstalten nach § 64 StGB , 2007 .

[10]  H. Dressing,et al.  Gutachterliche und therapeutische Probleme in der Umsetzung des § 64 StGB , 2006 .

[11]  B. Muthén Latent VariabLe Hybrids Overview of Old and new Models , 2006 .

[12]  P. Creed,et al.  The Use of Legal Coercion in the Treatment of Substance Abusers: An Overview and Critical Analysis of Thirty Years of Research , 2005, Substance use & misuse.

[13]  K. Larsen,et al.  Joint Analysis of Time‐to‐Event and Multiple Binary Indicators of Latent Classes , 2004, Biometrics.

[14]  G. H. de Weert-van Oene,et al.  Motivation for Treatment in Substance-Dependent Patients , 2002, European Addiction Research.

[15]  S. Gerl,et al.  Auswirkungen Des Bundesverfassungsgerichtsbeschlusses Vom 16.3.1994 Auf Die Unterbringung In Einer Entziehungsanstalt (§ 64 Stgb) Bei Alkoholabhängigen Und Polytoxikomanen , 2001 .

[16]  N. McGillicuddy,et al.  Treatment settings for persons with alcoholism: evidence for matching clients to inpatient versus outpatient care. , 2000, Journal of consulting and clinical psychology.

[17]  N. Schalast Rückfälle während der Behandlung im Maßregelvollzug gemäß § 64 StGB , 2000 .

[18]  J. Berger,et al.  Straffällige Alkohol- und Drogenabhängige , 1999 .

[19]  M. Soyka,et al.  Comments on Project MATCH: matching alcohol treatments to client heterogeneity. , 1999, Addiction.

[20]  C. O'brien,et al.  Problem-service 'matching' in addiction treatment. A prospective study in 4 programs. , 1997, Archives of general psychiatry.

[21]  M. Pagano,et al.  Survival analysis. , 1996, Nutrition.

[22]  D. Simpson,et al.  Motivation as a predictor of early dropout from drug abuse treatment. , 1993 .