Childhood Adversity and Psychosis in Detained Inpatients from Medium to High Secured Units: Results from the Scottish Census Survey

Thanos Karatzias, M Shevlin, Jamie Pitcairn, Lindsay Thomson, Adam Mahoney, Philip Hyland

Research output: Contribution to journalArticle

Abstract

Background
There is limited data available regarding the most common forms of psychiatric illness, the occurrence of childhood adversity, and the link between childhood adversity and criminal and psychiatric outcomes amongst forensic inpatients.
Aims
Using census data for all Scottish forensic inpatients, we investigated the most common primary psychiatric diagnoses in forensic settings, the occurrence of childhood adversity amongst forensic inpatients, and whether childhood adversity experiences significantly predict a range of criminal and psychiatric outcomes.
Method
Data for the current study were drawn from ‘The Scottish Forensic Network Inpatient Census’ (N = 422). The Responsible Medical Officers and other members of the clinical team collected all data from official patient records. All forensic inpatients across high, medium, and low security sites were surveyed.
Results
The majority of patients had a psychotic disorder as their primary diagnosis (86.4%), with schizophrenia being the most common (70.0%). Childhood adversity was highly prevalent (79.2%), with physical abuse being the most common adverse experience (40.1%). Increased levels of childhood adversity were significantly associated with an increased risk of criminal convictions, self-reported abuse of animals, suicidal and self-injurious behaviour, and problematic use of drugs or alcohol.
Conclusions
Considering the association between adversity and psychosis, trauma informed care is essential for the mental health and forensic needs of this population.
LanguageEnglish
JournalChild Abuse and Neglect
Publication statusAccepted/In press - 16 Jul 2019

Fingerprint

Censuses
Psychotic Disorders
Inpatients
Psychiatry
Self-Injurious Behavior
Mental Disorders
Schizophrenia
Mental Health
Alcohols
Surveys and Questionnaires
Wounds and Injuries
Pharmaceutical Preparations
Population

Keywords

  • childhood adversity
  • forensic patients
  • psychosis

Cite this

@article{133962086c084e51ba16324dfc749a3b,
title = "Childhood Adversity and Psychosis in Detained Inpatients from Medium to High Secured Units: Results from the Scottish Census Survey",
abstract = "BackgroundThere is limited data available regarding the most common forms of psychiatric illness, the occurrence of childhood adversity, and the link between childhood adversity and criminal and psychiatric outcomes amongst forensic inpatients. Aims Using census data for all Scottish forensic inpatients, we investigated the most common primary psychiatric diagnoses in forensic settings, the occurrence of childhood adversity amongst forensic inpatients, and whether childhood adversity experiences significantly predict a range of criminal and psychiatric outcomes.MethodData for the current study were drawn from ‘The Scottish Forensic Network Inpatient Census’ (N = 422). The Responsible Medical Officers and other members of the clinical team collected all data from official patient records. All forensic inpatients across high, medium, and low security sites were surveyed.Results The majority of patients had a psychotic disorder as their primary diagnosis (86.4{\%}), with schizophrenia being the most common (70.0{\%}). Childhood adversity was highly prevalent (79.2{\%}), with physical abuse being the most common adverse experience (40.1{\%}). Increased levels of childhood adversity were significantly associated with an increased risk of criminal convictions, self-reported abuse of animals, suicidal and self-injurious behaviour, and problematic use of drugs or alcohol.Conclusions Considering the association between adversity and psychosis, trauma informed care is essential for the mental health and forensic needs of this population.",
keywords = "childhood adversity, forensic patients, psychosis",
author = "Thanos Karatzias and M Shevlin and Jamie Pitcairn and Lindsay Thomson and Adam Mahoney and Philip Hyland",
year = "2019",
month = "7",
day = "16",
language = "English",
journal = "Child Abuse and Neglect",
issn = "0145-2134",
publisher = "Elsevier",

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Childhood Adversity and Psychosis in Detained Inpatients from Medium to High Secured Units: Results from the Scottish Census Survey. / Karatzias, Thanos; Shevlin, M; Pitcairn, Jamie ; Thomson, Lindsay ; Mahoney, Adam ; Hyland, Philip.

In: Child Abuse and Neglect, 16.07.2019.

Research output: Contribution to journalArticle

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T1 - Childhood Adversity and Psychosis in Detained Inpatients from Medium to High Secured Units: Results from the Scottish Census Survey

AU - Karatzias, Thanos

AU - Shevlin, M

AU - Pitcairn, Jamie

AU - Thomson, Lindsay

AU - Mahoney, Adam

AU - Hyland, Philip

PY - 2019/7/16

Y1 - 2019/7/16

N2 - BackgroundThere is limited data available regarding the most common forms of psychiatric illness, the occurrence of childhood adversity, and the link between childhood adversity and criminal and psychiatric outcomes amongst forensic inpatients. Aims Using census data for all Scottish forensic inpatients, we investigated the most common primary psychiatric diagnoses in forensic settings, the occurrence of childhood adversity amongst forensic inpatients, and whether childhood adversity experiences significantly predict a range of criminal and psychiatric outcomes.MethodData for the current study were drawn from ‘The Scottish Forensic Network Inpatient Census’ (N = 422). The Responsible Medical Officers and other members of the clinical team collected all data from official patient records. All forensic inpatients across high, medium, and low security sites were surveyed.Results The majority of patients had a psychotic disorder as their primary diagnosis (86.4%), with schizophrenia being the most common (70.0%). Childhood adversity was highly prevalent (79.2%), with physical abuse being the most common adverse experience (40.1%). Increased levels of childhood adversity were significantly associated with an increased risk of criminal convictions, self-reported abuse of animals, suicidal and self-injurious behaviour, and problematic use of drugs or alcohol.Conclusions Considering the association between adversity and psychosis, trauma informed care is essential for the mental health and forensic needs of this population.

AB - BackgroundThere is limited data available regarding the most common forms of psychiatric illness, the occurrence of childhood adversity, and the link between childhood adversity and criminal and psychiatric outcomes amongst forensic inpatients. Aims Using census data for all Scottish forensic inpatients, we investigated the most common primary psychiatric diagnoses in forensic settings, the occurrence of childhood adversity amongst forensic inpatients, and whether childhood adversity experiences significantly predict a range of criminal and psychiatric outcomes.MethodData for the current study were drawn from ‘The Scottish Forensic Network Inpatient Census’ (N = 422). The Responsible Medical Officers and other members of the clinical team collected all data from official patient records. All forensic inpatients across high, medium, and low security sites were surveyed.Results The majority of patients had a psychotic disorder as their primary diagnosis (86.4%), with schizophrenia being the most common (70.0%). Childhood adversity was highly prevalent (79.2%), with physical abuse being the most common adverse experience (40.1%). Increased levels of childhood adversity were significantly associated with an increased risk of criminal convictions, self-reported abuse of animals, suicidal and self-injurious behaviour, and problematic use of drugs or alcohol.Conclusions Considering the association between adversity and psychosis, trauma informed care is essential for the mental health and forensic needs of this population.

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