Prospective observational cohort study of 'treatment as usual' over four years for patients with schizophrenia in a national forensic hospital.

Background: We evaluated change in response to multi-modal psychosocial 'treatment as usual' programs offered within a forensic hospital.

Methods: Sixty nine patients with a diagnosis of schizophrenia or schizoaffective disorder were followed for up to four years. Patient progress was evaluated using the DUNDRUM-3, a measure of patient ability to participate and benefit from multi-modal psychosocial programs and the HCR-20 dynamic items, a measure of violence proneness.