Risk evaluation of relapse into violent crime in offenders with mental disorders in two different rehabilitation programs: a case-control study.

INTRODUCTION: Over the last years, many research groups have been working on evaluating the most appropriate rehabilitation approaches in offenders with mental disorders, taking into account the need to prevent crime reiteration. The HKT-R (Historisch Klinisch Toekomst- Revised), recently validated in Italy, is a comprehensive tool that offers useful indications to healthcare operators on relapse hazard and major risk areas on which intensify rehabilitation treatments. The present study aims to assess the risk of violent crime recidivism in psychiatric patients during different rehabilitative pats. MATERIALS&METHODS: the risk of violent crime recidivism was assessed by using the HKT-R in 34 patients with mental disorders treated in ordinary psychiatric therapeutic rehabilitative units (CRAP - Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche) and in CRAP-D (Comunità Terapeutiche Riabilitative Assistenziali Psichiatriche Dedicate) specialized in crime offenders. RESULTS AND CONCLUSIONS: Results have demonstrated a higher risk of violent behavior in CRAP-D, and a negative correlation between the risk of violent recidivism, global functioning of patients, and length of care program. These data suggest that residential rehabilita-tion programs, by improving personal and social functioning, could negatively impact the risk of violent crime recidivism, especially in patients with severe mental illness.

Italian standardization of the Apples Cancellation Test.

Hemispatial neglect due to right parieto-temporo-frontal lesions has a negative impact on the success of rehabilitation, resulting in poor functional gain. Recent research has shown that different types of neglect can impact in a different way on rehabilitation outcomes. The availability of a sensitive test, useful for distinguishing egocentric and allocentric forms of neglect, may be clinically important as all current clinical instruments fail to distinguish between these forms of disturbance, yet they differentially predict outcome. The Apples Test is a new instrument useful to evaluate both egocentric and allocentric forms of neglect. In order to establish Italian norms for this diagnostic instrument the test was administered to a sample of 412 healthy people of both genders (201 M and 211 F), aged from 20 to 80 years enrolled from 14 different rehabilitation centers in Italy. Based on the data, we established pathological performance cut-offs for the accuracy score (total omission errors), the asymmetry score for egocentric neglect (omission error difference), the asymmetry score for allocentric neglect (commission error difference) and execution time. The usefulness of the Apples Test for diagnostic purposes is illustrated by presenting three patients with different forms of neglect (egocentric, allocentric and mixed neglect).