Optimization of preventive measures and the medical and social strategy for the rehabilitation of persons who have committed socially dangerous acts at the stage of out-of-hospital care (by way of example of the Dispensary Department of Tomsk Clinical Psy

Optimization of preventive measures and the medical and social strategy for the rehabilitation of persons who have committed socially dangerous acts at the stage of out-of-hospital care (by way of example of the Dispensary Department of Tomsk Clinical Psychiatric Hospital)

 

Authors

 

S.M. Andreev

Regional State Autonomous Healthcare Institution “Tomsk Clinical Psychiatric Hospital”, Tomsk, Russian Federation

E.O. Starinskaya

Regional State Autonomous Healthcare Institution “Tomsk Clinical Psychiatric Hospital”, Tomsk, Russian Federation

I.A. Kal’chenko

Regional State Autonomous Healthcare Institution “Tomsk Clinical Psychiatric Hospital”, Tomsk, Russian Federation

 

https://doi.org/10.26617/1810-3111-2023-3(120)-29-36

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 3 (120):  29-36.

 

Abstract

Background. The high prevalence and criminogenic significance of mental disorders determine the interest of researchers in the modernization of preventive and social rehabilitation programs with their subsequent introduction into the practice of psychiatric service. Objective: based on the results of the analysis of the clinical, psychopathological and socio-demographic characteristics of patients who have committed socially dangerous actions (SDA) and are under active dispensary observation (ADO), to develop proposals for optimizing preventive measures and medical and social rehabilitation strategies. Research Material. A continuous study was performed based on the Dispensary Department of Tomsk Clinical Psychiatric Hospital. The research sample included patients (n=677) with diagnosed mental disorders who were under ADO in 2020-2022. The current mental state of the patients was assessed according to the ICD-10 diagnostic criteria. From the general sample of the study, two groups of patients were formed, placed under ADO: the 1st group ‒ those who had previously undergone a course of compulsory inpatient and outpatient treatment prescribed in connection with the committed SDA, the 2nd group ‒ selected on the initiative of the doctors of the Dispensary Department in connection with the presence in probands of antisocial tendencies. Methods: clinical-psychopathological, clinical-dynamic, pathopsychological, statistical. Results. The proportion of patients with SDA and antisocial tendencies who were under ADO was approximately the same in each year of observation, slightly exceeding 5%. A gradual increase in the number of patients in the 1st group compared with patients in the 2nd group was revealed. More than 75% of patients in both groups suffered from schizophrenia spectrum disorders, about 10% ‒ mental retardation, more than 8% ‒ mental disorders due to epilepsy, the proportion of personality disorders was minimal (2.7% and 5.7%). The main reasons for placing patients with SDA under ADO were determined: aggressive actions against relatives or neighbors, sexual pretensions, violations of public order (hooligan actions against others), suicidal thoughts and behavior. Only patients of the 1st group committed serious SDA: murders, infliction of serious and moderate bodily harm, and robberies. Antisocial tendencies of patients of the 2nd group were manifested in the form of aggression towards relatives and others and suicidal ideation. In both groups, males predominated, the age category from 31 to 50 years old, lived alone and single, persons with a formalized disability group according to the decision of a specialized psychiatric MSE, most of whom were disabled of the second group due to mental illness. Based on the discussed data, a social portrait of a patient with a mental disorder under ADO was compiled. It was concluded that without the development and inclusion of SDA prevention measures and a medical and social rehabilitation strategy in a comprehensive personalized therapy program, the potential risk of social danger of this contingent of mentally ill patients increases.

 

Keywords: active dispensary observation of the mentally ill persons, socially dangerous actions, antisocial tendencies, prevention, medical and social rehabilitation.

 

Article (pdf)

 

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Materials  

For citation: Andreev S.M., Starinskaya E.O., Kal’chenko I.A. Optimization of preventive measures and the medical and social strategy for the rehabilitation of persons who have committed socially dangerous acts at the stage of out-of-hospital care (by way of example of the Dispensary Department of Tomsk Clinical Psychiatric Hospital). Siberian Herald of Psychiatry and Addiction Psychiatry.2023; 3 (120): 29-36. https://doi.org/10.26617/1810-3111-2023-3(120)-29-36

 

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