Historical, clinical and situational risk factors for post-discharge recidivism in forensic psychiatric patients - A Swedish registry study.

Objective: To investigate which factors, known at the time of discharge, correlate with post-discharge recidivism in forensic psychiatric patients in Sweden.

Subjects And Methods: A database was constructed based on registry data taken from the Swedish National Forensic Psychiatric Register, as well as data on post-discharge convictions sourced from the National Council of Crime Prevention and demographic data from Statistics Sweden. The sample consisted of all individuals discharged from forensic psychiatric services in Sweden during 2009-2018 (n = 1150), and the follow-up period was 2009-2018. Survival analyses were used to investigate predictors of an increased likelihood for recidivism using both bivariate comparisons and multivariate Cox regression analyses.

Results: The Cox regression analyses showed that out of the demographic background factors, higher age at discharge was significantly associated with a lower likelihood of recidivism within the follow-up period. The two discrete historical factors of having a history of substance abuse and having been sentenced before the index crime, and the clinical factor of presence of personality disorder without the presence of psychosis were associated with an increase in the likelihood of recidivism. The situational factors of having a trustee or limited guardian and main living accommodation being supported living were associated with a decrease in the likelihood of recidivism. The results support previous research regarding historical and pre-treatment factors, but also show that situational factors related to increased support and supervision in everyday life are associated with a decreased likelihood of recidivism. This knowledge may help the administrative courts and forensic psychiatric services to prevent future recidivism.