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      Zum Ertrag der Unterbringung in einer Entziehungsanstalt und zu methodischen Einwänden gegen die Essener Evaluationsstudie Translated title: Forensic Addiction Treatment in Germany: an Evaluation of its Effects on Criminal Recidivism and a Response to Critical Comments

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          Zusammenfassung

          Der Bewährungserfolg einer Gruppe ehemaliger Patienten des § 64-Maßregelvollzugs und einer gematchten Vergleichsgruppe von Strafgefangenen wurde nach Entlassung in die Freiheit anhand von BZR-Auskünften verglichen.

          Methodik 16 Kliniken übermittelten zu mehreren Zeitpunkten pseudonymisierte Daten. Zu jedem Patienten des MRV wurde anhand eines Merkmalschemas ein Vergleichsfall im Strafvollzug identifiziert.

          Ergebnisse Beim Vergleich der Bewährungsverläufe über mehr als 4 Jahre zeigen sich hochsignifikante Vorteile der Interventionsgruppe (MRV) gegenüber der Kontrollgruppe (JVA), und zwar bei Einschluss auch aller Patienten mit ungünstigem Behandlungsverlauf.

          Diskussion Die Ergebnisse rechtfertigen nachdrücklich die Beibehaltung einer „Entziehungsmaßregel“.

          Abstract

          In Germany, offenders with addiction problems may be sentenced to treatment in forensic psychiatric hospitals. A considerable share of patients, in some hospitals more than 40 percent, is returned to prison. The paper presents findings of a long-term evaluation study.

          Method 16 hospitals participated and provided data on patients’ background and course of treatment. The Federal Office of Justice reported on patients’ conduct after discharge in terms of new entries in the federal criminal register (FCR). A matched sample of controls – prisoners with addiction problems – was recruited referring to a schema of criminological characteristics.

          Findings The former patients’ social adjustment was significantly better than the former prisoners’: the total risk reduction (less new FCR-entries) amounted over 20 percent (effect-size b Cohen  > 0.45). This comparison included all patients returned to prison.

          Discussion The treatments reveal – in total – a significant and substantial effect in favor of patients’ later adjustment, though a too large subgroup of patients is returned to prison.

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          Most cited references36

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          The effects of sexual offender treatment on recidivism: an international meta-analysis of sound quality evaluations

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            Are randomised controlled trials the only gold that glitters?

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              All-cause mortality in criminal justice clients with substance use problems--a prospective follow-up study.

              Mortality in previously incarcerated individuals is known to be elevated, with high proportions of drug-related deaths. However, there is less documentation of whether specific substance use patterns and other clinical characteristics predict increased mortality in the group. This is a follow-up study of mortality and causes of death in ex-prisoners with substance use problems prior to incarceration (N=4081), who were followed during an average of 3.6 years from release from prison until death or until data were censored. Baseline predictors of mortality, derived from interviews with Addiction Severity Index (ASI) in prison, were studied in a Cox regression analysis. During follow-up, 166 subjects (4.1%) died. Standardized mortality ratios were 7.0 (3.6-12.2) for females and 7.7 (5.6-9.0) for males. In 84% of cases, deaths were unnatural or due to substance-related disease. Most common causes of death were accidental poisoning (27%), transport accidents (13%), poisoning/injury with undetermined intent (12%), and suicide (10%). Death was positively predicted by heroin use, overdose, and age, and negatively predicted by a history of depression. A vast majority of deaths after release from prison in individuals with substance use are due to violent or substance-related causes. Significant predictors identified were mainly related to patterns of drug use, and need to be addressed upon incarceration as risk factors of death. The findings have implications for referral and treatment upon release from prison. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                Psychiatr Prax
                Psychiatr Prax
                10.1055/s-00000062
                Psychiatrische Praxis
                Georg Thieme Verlag KG (Rüdigerstraße 14, 70469 Stuttgart, Germany )
                0303-4259
                1439-0876
                November 2021
                05 November 2021
                1 November 2021
                : 48
                : 8
                : 412-420
                Affiliations
                [1 ]Institut für forensische Psychiatrie, Medizinische Fakultät, Universität Duisburg-Essen
                [2 ]Abteilung für forensische Psychiatrie, LVR-Klinik Viersen
                Author notes
                Korrespondenzadresse Dr. Norbert Schalast Institut für forensische Psychiatrie, Medizinische Fakultät, Universität Duisburg-Essen Virchowstraße 17445147 EssenDeutschland norbert.schalast@ 123456lvr.de
                Article
                10.1055/a-1540-5378
                8747946
                34741285
                e5df93e1-72c6-4465-a595-95c59e968c20
                Thieme. All rights reserved.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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                Categories
                Originalarbeit

                entziehungsanstalt,evaluationsstudie,gematchte vergleichsgruppe,überlebenszeitanalyse,legalbewährung,forensic addiction treatment,matched control sample,survival analysis,impact of treatment

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