Comparing forensic and non-forensic women with schizophrenia spectrum disorders: a European study

Figures & data

Table 1. Socio-demographic characteristics of female forensic patients with ssd and controls.

	Forensic group N = 26 N (%)	Control group N = 36 N (%)	p-value
Country of recruitment
Austria	4 (15.4%)	4 (11.1%)	.431
Germany	6 (23.1%)	8 (22.2%)
Italy	2 (7.7%)	3 (8.3%)
Poland	8 (30.0%)	18 (50.0%)
United Kingdom	6 (23.1%)	3 (8.3%)
Ethnicity
White	24 (92.3%)	34 (94.4%)	.538
Middle Eastern or Arab (incl. all North African nations)	0	1 (2.8%)
Asian	1 (3.8%)	0
Black/African/ Central or South American (Hispanic)	0	0
Don’t know/won’t say	1 (3.8%)	1 (2.8%)
Age (Years), Mean (SD)	42.4 (12.4)	35.4 (9.0)	.012
Marital status
Married or cohabiting	2 (7.7%)	3 (8.3%)	.265
Single	18 (69.2%)	30 (83.4%)
Divorced or widowed	6 (23.1%)	3 (8.3%)
Children
Yes	16 (61.5%)	32 (88.9%)	.011
No	10 (38.5%)	4 (11.1%)
Education years, Mean (SD)	12.3 (2.5)	14.0 (3.4)	.027
Highest occupational status
Never worked/ Student/housewife	2 (7.7%)	6 (16.7%)	.753
Unskilled worker	11 (42.3%)	13 (36.1%)
Skilled worker	11 (42.3%)	15 (41.7%)
Professional	2 (7.7%)	2 (5.6%)
Social support #
None	4 (15.4%)	4 (11.1%)	–
Family	20 (76.9%)	29 (80.6%)
Friends	8 (30.8%)	10 (27.8%)
Other patients	4 (15.4%)	1 (2.8%)
All	0	0

#Multiple-choice question: chi-square test was not possible.

Table 2. Criminological and clinical characteristics of the forensic sample at the time of the index violence.

	Forensic cases N = 26 N (%)
Type of crime (index violence)
Homicide	12 (46.2)
Attempted homicide	3 (11.5)
Assault with injury	7 (26.9)
Used a weapon/force	1 (3.8)
Other	3 (11.5)
Type of index violence
Reactive/Impulsive	15 (62.5)
Premeditated	9 (37.5)
Abnormal mental state (during the index violence)
No	0 (0)
Yes	26 (100)
Type of abnormal mental state (during the index violence)
Psychotic disorder	26 (100)
Mood disorder	0 (0)
Other	0 (0)
Substance use disorders (at the time of the index violence)
No	13 (56.5)
Yes	10 (43.5)
Already in contact with MHS (at the time of the index violence)
No	5 (20.0)
Yes	20 (80.0)
Diagnosis before the index violence if already in contact with MHS
Psychotic disorder	18 (90.0)
Personality disorder	1 (5.0)
Mood disorder	1 (5.0)
Prescribed medications (at the time of the index violence)
Antipsychotics	14 (82.4)
Antidepressants	1 (5.9)
Mood stabilizer	2 (11.8)
Pharmacological compliance (at the time of the index violence)
No	17 (94.4)
Yes	1 (5.6)
History of conviction or arrest for the index violence: FIRST admission at the time of index violence
No	5 (19.2)
Yes (current forensic unit)	7 (26.9)
Yes (another forensic unit)	5 (19.2)
Yes (prison)	9 (34.6)

Table 3. Clinical characteristics of female forensic patients with ssd and controls.

	Forensic group N = 26 N (%)	Control group N = 36 N (%)	p-value
Illness duration (Years), Mean (SD)	15.4 (10.6)	9.3 (7.9)	.016
Age of first contact with DMHs (Years), Mean (SD)	27.0 (11.2)	23.1 (8.3)	.133
Type of SSD diagnosis
Schizophrenia	22 (84.6%)	28 (77.8%)	.184
Schizoaffective disorders	2 (7.7%)	8 (22.2%)
Delusional disorder	1 (3.8%)	0
Brief psychotic disorder	0	0
Schizophreniform disorder	1 (3.8%)	0
Drug-induced psychosis	0	0
Comorbidity with Personality disorders
No	16 (64.0%)	33 (94.3%)	.003
Yes	9 (36.0%)	2 (5.7%)
Type of Comorbid personality disorders
Borderline personality disorder	6 (66.7%)	1 (50.0%)	.391
Antisocial personality disorder	2 (22.2%)	0
Other	1 (11.1%)	1 (11.1%)
Lifetime substance use
Never	12 (46.2%)	13 (37.1%)	.479
Yes	14 (53.8%)	22 (62.9%)
Lifetime attempted suicide/self-harm behaviours
Yes	12 (46.2%)	16 (47.1%)	.944
No	14 (53.8%)	18 (52.9%)
Collaboration skills in the last year
Actively seeks treatment, willing to collaborate	13 (50.0%)	25 (69.4%)	.275
Wants to be helped, but lacks motivation	3 (11.5%)	4 (11.1%)
Passively accepts the treatment/intervention	7 (26.9%)	5 (13.9%)
Does not show attention or compreh. for treatment efforts	1 (3.8%)	2 (5.6%)
Actively refuses the treatment/intervention	2 (7.7%)	0
Medications
No	0	1 (2.8%)	.392
Yes	26	35 (97.2%)
Antipsychotics
No	0	0	–
Yes	26	35

Table 4. Clinician-administered assessment tools in female forensic patients with ssd and controls.

	Forensic group N = 26 Mean, SD	Control group N = 36 Mean, SD	p-value
PANSS
Positive symptoms	16.4 (7.3)	15.7 (6.2)	.700
Negative Symptoms	18.7 (5.9)	18.1 (7.5)	.766
General psychopathology	35.8 (12.1)	35.4 (10.5)	.877
Total score	72.1 (22.9)	69.0 (22.8)	.624
WHODAS 2.0
Total score	7.0 (6.8)	16.7 (7.6)	<.001
BACS
Verbal memory #	37.6 (12.3)	37.3 (13.7)	.937
Working memory#	15.3 (3.3)	16.2 (4.7)	.412
Token motor task #	58.0 (14.4)	65.1 (18.0)	.121
Verbal fluency #	40.9 (12.1)	45.2 (14.4)	.244
Symbol coding task #	40.5 (9.7)	44.2 (11.1)	.206
Tower of London #	12.7 (5.4)	15.3 (4.2)	.050

PANSS: positive and negative syndrome scale; WHODAS 2.0: World Health Organisation Disability Assessment Schedule 2.0; BACS: brief assessment of cognition in schizophrenia.

#Raw scores.

Table 5. History of victimisation and violence in female forensic patients with ssd and controls.

	Forensic group N = 26 N (%)	Control group N = 36 N (%)	p-value
Witness of physical and/or sexual violence in the family
Yes	9 (34.6%)	12 (36.4%)	.889
No	17 (65.4%)	21 (63.6%)
When witness of violence
Early childhood – Childhood - Adolescence (0-18 years)	7 (77.8%)	11 (91.7%)	.368
Adulthood	2 (22.2%)	1 (8.3%)
Frequency of witness of violence?
Rarely	2 (25.0%)	8 (66.7%)	.034
Occasionally	1 (12.5%)	3 (25.0%)
Often	5 (62.5%)	1 (8.3%)
Medical attention needed after witnessed violence
Yes	2 (22.2%)	1 (8.3%)	.368
No	7 (77.8%)	11 (91.7%)
Victim of physical and/or sexual violence in the family
Yes	9 (36.0%)	10 (30.3%)	.647
No	16 (64.0%)	23 (69.7%)
When victim of violence
Early childhood – Childhood - Adolescence (0-18 years)	6 (75.0%)	8 (80.0%)	.800
Adulthood	2 (25.0%)	2 (20.0%)
Frequency of victim of violence
Rarely	2 (28.6%)	6 (60.0%)	.023
Occasionally	1 (14.3%)	4 (40.0%)
Often	4 (57.1%)	0
Medical attention needed after violence
Yes	2 (25.0%)	1 (10.0%)	.396
No	6 (75.0%)	9 (90.0%)
Beaten, kicked or punched by someone?
Yes	16 (64.0%)	11 (33.3%)	.020
No	9 (36.0%)	22 (66.7%)
When beaten, kicked or punched
Early childhood – Childhood - Adolescence (0-18 years)	7 (43.8%)	6 (54.5%)	.581
Adulthood	9 (56.3%)	5 (45.5%)
Frequency of beaten, kicked or punched
Rarely	7 (53.8%)	8 (72.7%)	.575
Occasionally	3 (23.1%)	2 (18.2%)
Often	3 (23.1%)	1 (9.1%)
Medical attention needed after having beaten, kicked or punched
Yes	3 (20.0%)	1 (9.1%)	.446
No	12 (80.0%)	10 (90.9%)

Table 6. Results of logistic models. association between socio-demographic and clinical variables (independent variables) and the two groups (cases vs controls).

Independent variable (reference category)	Odds Ratio [95% CI]	p-value
Age (Years)	1.02 [1.00–1.05]	.050
Education years	0.88 [0.82–0.95]	.002
Comorbidity with Personality disorders (Yes)	4.02 [1.91–8.46]	<.001
WHODAS 2.0 Total score	0.92 [0.89–0.95]	<.001
Beaten, kicked or punched by someone (Yes)	2.46 [1.42–4.24]	.001

Data availability statement

The project will fully embrace the open access data policy of H2020 to make data FAIR (Findable, Accessible, Interoperable, and Re-usable), and all data gathered in the framework of the project are stored in a public repository (https://doi.org/10.5281/zenodo.4442372) accessible to all scientists willing to carry out additional analyses.