Аннотация:
Background. The social significance of the prevention of public danger of persons with mental disorders is largely determined by the risk of committing serious offenses by such patients, as well as a high rate of their recurrence, therefore, forecasting the likelihood and improving the effectiveness of the prevention of recidivism of criminalization are urgent tasks of the activities of psychiatric services specialists.
Aim: to determine the predictors of repeated illegal behavior and to develop a predictive model of the probability of relapse of public danger.
Methods. The research sample (n=160) was formed from two groups of patients: the main (n=80) – severe mental disorders and repeated illegal behavior; comparison (n=80) – severe mental disorders, law-abiding behavior. Nominal data were described with absolute values and percentages. Nominal data were compared using Pearson’s χ2 test, which assesses the significance of differences between the actual number of outcomes or qualitative characteristics of the sample falling into each category and the theoretical number that can be expected in the studied groups if the null hypothesis is true. The construction of a predictive model for the probability of a certain outcome was carried out using the binary logistic regression method. Nigelkirk’s R² served as a measure of certainty indicating that part of the variance that can be explained by logistic regression. The predictive abilities of the developed model of the probability of recurrence of public danger and the critical separating value were calculated using the ROC-curves analysis method. The separating value of the quantitative trait at the cut-off point was determined by the highest value of the Youden index. The critical level of significance in testing statistical hypotheses was taken equal to p < 0.05.
Results. Statistically significant social, clinical, anamnestic factors and psychological characteristics that influence the risk of repeated commission of socially dangerous actions are identified. A prognostic model for assessing the risk of relapse of public danger has been developed, its statistical significance has been proved (p<0.001). The prognostic capabilities of the model were evaluated using the ROC analysis method: the area under the ROC curve (AUC) is 0.996 ± 0.005 with 95% CI: 0.986 – 1,000, (p<0.001), sensitivity and specificity were 96.2% and 97.1%, respectively.
Conclusion. The information obtained contributes to understanding the genesis of repeated socially dangerous behavior of patients with severe mental disorders, their application will increase the validity and evidence of risk assessment.
Ключевые слова:
mental disorders, illegal behavior, repeated socially dangerous actions, prevention, risk assessment, prognostic model.