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The following is a summary of “Dynamic risk and protective factors in mentally disordered offenders: forensic psychiatry treatment monitoring, prison release and length of stay,” published in the May 2025 issue of BMC Psychiatry by Weber et al. 

The reduction of violence risk and recidivism served as a key indicator of treatment progress in forensic psychiatry and informed discharge decisions from prison-based security clinics. 

Researchers conducted a retrospective study to examine the relationship between dynamic and static risk factors, integrated risk-protection assessment, and treatment outcomes, including discharge decisions, in forensic psychiatry. Special attention was given to individuals diagnosed with schizophrenia, a prevalent condition in forensic populations, due to its complex association with both risk and treatment responsiveness. 

They monitored treatment-as-usual changes in violence and protective factors over 2 years in 117 offenders—many of whom had schizophrenia—at a medium-security forensic clinic in Switzerland using a repeated measures design. Mixed-effects and multinomial logistic regression models predicted the longitudinal evolution of risk and protection, length of stay, and discharge destinations. 

The results showed forensic psychiatry treatment reduced dynamic risk and increased protection, unlike static risk. After 18–24 months, protective factors balanced risk factors. Numeric scales and structured professional judgment both indicated significant risk improvement over time. However, protection and integrated risk-protection ratings by structured judgment showed no significant treatment change. Discharge to low-security psychiatry wards was predicted by favorable baseline risk, protection, and integrated risk-protection, not by their changes during treatment. Longer stays were predicted solely by higher baseline total risk. 

Investigators concluded that determining dynamic from static risk and incorporating integrated risk-protection measures were essential, particularly in cases involving schizophrenia, where baseline risk profiles more strongly influenced treatment duration and discharge outcomes than progress in protective factors during treatment. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06958-2