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Olagunju AT, Bouskill SL, Olagunju TO, et al. Absconsion in forensic psychiatric services: a systematic review of literature. CNS Spectr. 2020;1-12doi: 10.1017/S1092852920001881.
Olagunju, A. T., Bouskill, S. L., Olagunju, T. O., Prat, S. S., Mamak, M., & Chaimowitz, G. A. (2020). Absconsion in forensic psychiatric services: a systematic review of literature. CNS spectrums, 1-12. https://doi.org/10.1017/S1092852920001881
Olagunju, Andrew T, et al. "Absconsion in forensic psychiatric services: a systematic review of literature." CNS spectrums vol. (2020): 1-12. doi: https://doi.org/10.1017/S1092852920001881
Olagunju AT, Bouskill SL, Olagunju TO, Prat SS, Mamak M, Chaimowitz GA. Absconsion in forensic psychiatric services: a systematic review of literature. CNS Spectr. 2020 Oct 07;1-12. doi: 10.1017/S1092852920001881. Epub 2020 Oct 07. PMID: 33023708.
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CNS Spectr. 2020 Oct 07;1-12. doi: 10.1017/S1092852920001881. Epub 2020 Oct 07.

Absconsion in forensic psychiatric services: a systematic review of literature.

CNS spectrums

Andrew T Olagunju, Stephanie L Bouskill, Tinuke O Olagunju, Sebastien S Prat, Mini Mamak, Gary A Chaimowitz

Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University/St Joseph Healthcare Hamilton, Hamilton, Ontario, Canada.
  2. Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia.
  3. Department of Psychiatry, University of Lagos, Lagos, Nigeria.
  4. Department of Health Research Methodology, McMaster University, Hamilton, Ontario, Canada.

PMID: 33023708 DOI: 10.1017/S1092852920001881

Abstract

While serious concerns are often raised when patients abscond or leave unauthorized from psychiatric services, there is limited knowledge about absconsion in forensic psychiatric services. Following the preferred reporting items for systematic reviews and meta-analyses guideline, we searched Medline/PubMed, PsycINFO, EMBASE, CINAHL, Scopus, and Web of Science through May 2020 for eligible reports on absconsion in forensic patients with no language limits. The search string combined terms for absconsion, forensic patients, and psychiatry in various permutations. This was supplemented by snowball searching for additional studies. Of the 565 articles screened, 25 eligible studies, including two interventional, seven cross-sectional, and 16 case-controlled studies spanning five decades were included. Absconsion and re-absconsion rates ranged from 0.2% to 54.4% and 15% to 71%, respectively, albeit higher rates trended with less secure psychiatric units. Previous absconsion, aggression, substance use, high Historical Clinical Risk Management-20 score, anti-sociality, psychiatric symptoms, sexual offending, and poor treatment adherence were the factors reported with a degree of predictive value for absconsion. However, the construct of absconsion was heterogeneous in the included studies and the quality of evidence on the predictors of absconsion was limited. Serious risky behaviors including re-offending, violence, self-harm, suicide, rape, and manslaughter were perpetrated by patients during unauthorized leave. Nevertheless, the rates of re-offending were generally low in the included studies (highest recidivism rate = 0.11). There is need for standardized assessment and documentation of absconsion to improve risk analysis and management. Furthermore, it is necessary to develop a structured guideline for defining absconsion, and to create a protocol that operationalizes all absconsion-related behaviors/events to promote reliable assessment and comparative analysis in future studies.

Keywords: Associated factors; elopement; escape; forensic psychiatry; predictors

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