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Seishin Igaku Volume 61, Issue 5 （May 2019）

精神医学 61巻5号（2019年5月発行）

Japanese English

研究と報告

措置入院患者と医療観察法対象者の比較に基づく現状と支援に関する検討 A Study on Present Condition and Support based on Comparison between Compulsorily Hospitalized Patients and Patients Subject to the Medical Care and Supervision Act 小池純子 ^1,2,3 , 常岡俊昭 ^2,4 , 池田朋広 ⁵ , 黒田治 ³ , 針間博彦 ³ , 小池治 ³ , 稲本淳子 ^2,6 Junko Koike ^1,2,3 , Toshiaki Tuneoka ^2,4 , Tomohiro Ikeda ⁵ , Osamu Kuroda ³ , Hirohiko Harima ³ , Osamu Koike ³ , Junko Inamoto ^2,6 ¹国立精神・神経医療研究センター精神保健研究所地域・司法精神医療研究部 ²昭和大学医学部精神医学講座 ³東京都立松沢病院 ⁴昭和大学附属烏山病院 ⁵高崎健康福祉大学健康福祉学部社会福祉学科 ⁶昭和大学横浜市北部病院 ¹Department of Community Mental Health and Law, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan ²Department of Psychiatry, Showa University School of Medicine ³Tokyo Metropolitan Matsuzawa Hospital ⁴Department of Psychiatry, Showa University Karasuyama Hospital ⁵Department of Social Work, Takasaki University of Health and Welfare ⁶Department of Psychiatry, Showa University Northern Yokohama Hospital キーワード： Mentally disordered offenders , Committed other-injuring Behavior , Involuntary admission , Medical and supervision act , Preventive supports Keyword: Mentally disordered offenders , Committed other-injuring Behavior , Involuntary admission , Medical and supervision act , Preventive supports pp.583-593

発行日 2019年5月15日 Published Date 2019/5/15

DOI https://doi.org/10.11477/mf.1405205835

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抄録　目的：措置入院患者と医療観察法対象者の特性の比較を行い，両者の共通点と相違点を把握し，おのおのの支援上の重点課題と現在の措置入院制度の役割を考察する。

　方法：他害行為を契機に入院した措置患者125名と，医療観察法対象者38名の計163名を対象に，後方視野的研究を行った。

　結果：措置群，観察法群ともに生活保護受給者が多く，家族の支援に乏しい生活上の困難を抱えていた。観察法群では思考の障害，不定期受診者，過去の触法経歴と措置入院経歴を有する者の割合が高かった。

　考察：措置入院は，その後の再他害行為，重大な他害行為を未然に防ぐ機会になるため，他害行為の予防に関連した支援を図る制度への転換が望まれる。

　Objective：To compare characteristics between compulsorily hospitalized patients and patients subject to the Medical Care and Supervision Act in order to understand the characteristics that are common to and those that differ between the two groups of patients and to discuss major issues in the two support systems and the current role for the compulsory hospitalization system.

　Methods：A retrospective study was conducted with patients involuntarily admitted to mental hospitals through the Japanese forensic mental health system over a period of 2 years. Comparison focused on the occurrence of violent recidivism and timing of the occurrence of symptoms, and characteristics were elicited.

　Results：Participants comprised 163 people, with the most common diagnosis being schizophrenia. The group exhibiting violent recidivism had a high frequency of past stays and involuntary admission in mental hospitals. In terms of life situation, they had meagre work experience, and poor support from family or a key person. Significant proportions of subjects in the supervised group had impaired thinking, received medical care irregularly, violated a law previously, or had a history of compulsory hospitalization.

　Discussion：The system should shift the focus to relevant to the prevention of harmful behavior towards others, since compulsory hospitalization is one of opportunities to prevent harmful behavior from recurring or worsening.