Mapping Systematic Reviews on Forensic Psychiatric Care: A Systematic Review Identifying Knowledge Gaps

Area of Science:

• Forensic Psychiatry
• Mental Health Research
• Evidence-Based Practice

Background:

• Forensic psychiatric care serves mentally disordered offenders, often with complex comorbidities and histories of violent crime.
• Care is involuntary, balancing patient rehabilitation with societal risk management.
• Existing research in this field is critically reviewed.

Purpose of the Study:

• To identify, appraise, and summarize existing knowledge in forensic psychiatric care.
• To pinpoint knowledge gaps requiring further investigation.
• To assess the quality of evidence across key domains of forensic care.

Main Methods:

• A systematic literature search for systematic reviews was conducted across five domains: assessment, pharmacological treatment, psychological interventions, psychosocial interventions/rehabilitation, and restraint interventions.
• Reviews were assessed for bias, with those having moderate or low risk of bias included.
• The target population was mentally disordered offenders aged over 15 years.

Main Results:

• Of 38 systematic reviews, only four had a moderate risk of bias; however, most primary studies within these reviews exhibited high risks of bias.
• Consequently, no definitive conclusions could be drawn from the reviewed literature.
• All five investigated domains were identified as significant knowledge gaps.

Conclusions:

• The current body of research in forensic psychiatric care is insufficient to answer key clinical questions due to high bias in primary studies.
• There is an urgent need for rigorous, high-quality research across all domains of forensic psychiatric care.
• Significant knowledge gaps persist, hindering evidence-based practice in this complex field.