Patients Admitted to a Maximum Security Forensic Psychiatry Unit in Norway: A Case File Analysis of Demographic,Psychosocial,Clinical and Criminal Characteristics

Abstract

Every year, 25 to 30 patients are admitted to the maximum security unit at Ullevål University Hospital in Oslo, Norway. The unit has 25 beds and covers a catchment area of some 2.4 million inhabitants. The main scope of this study was to monitor and analyze demographic, psychosocial, clinical, and criminal characteristics of the patient population, with a special focus on possible associations between psychosocial conditions, mental illness, substance abuse, violence, and criminality. Three independent raters scrutinized hospital case files from index hospitalization of all patients (N = 125) that had been admitted during a 4-year period. A codebook specially developed for this research was used, and the scoring was subsequently determined by consensus between the raters. Being exposed to physical or sexual abuse in childhood was associated with the father being mentally ill (multivariate logistic regression, OR = 19.4, 95% CI = 3.4–111). Having a history of violence was associated with previous conviction (OR = 2.6, 95% CI = 1.01–6.8). Homicide was associated with personality disorder (OR = 19.0, 95% CI = 1.9–187.0) and having previously been admitted to a psychiatric institution (OR = 9.9, 95% CI = 2.5–39.4). Our findings are discussed in relation to methodological flaws and other research in the area.