ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2018
Prediction of violent crime on discharge from secure psychiatric hospitals: A clinical prediction rule (FoVOx).
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Violence risk assessment instruments in forensic psychiatric populations: a systematic review and meta-analysis.The lancet. Psychiatry · 2023Pooled it
- Use of risk assessment instruments to predict violence in forensic psychiatric hospitals: a systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2018Pooled it
- Improving risk assessment in forensic mental health: Temporal validation and clinical refinement of the FoVOx risk tool.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Dynamic prediction of reoffending in individuals given community sentences: Development and validation of a novel risk monitoring assessment tool (oxMore).Law and human behavior · 2026Article
- Does compulsory community treatment for discharged forensic hospital patients work? The recent evidence base.CNS spectrums · 2025Article
- Integrating static and modifiable risk factors in violence risk assessment for forensic psychiatric patients: a feasibility study of FoVOx.Nordic journal of psychiatry · 2023Article
- Effects of Psychiatric Disease Severity and Clinical Characteristics on Duration of High Violence Risk: A Perspective on Violence Prevention in the Psychiatric Ward.Neuropsychiatric disease and treatment · 2023Article
- A genetically informed prediction model for suicidal and aggressive behaviour in teens.Translational psychiatry · 2022Article
- Predicting self-harm in prisoners: Risk factors and a prognostic model in a cohort of 542 prison entrants.European psychiatry : the journal of the Association of European Psychiatrists · 2020Article
- European violence risk and mental disorders (EU-VIORMED): a multi-centre prospective cohort study protocol.BMC psychiatry · 2019Article
- A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool.Frontiers in psychiatry · 2019Article
- Violent Behavior During Psychiatric Inpatient Treatment in a German Prison Hospital.Frontiers in psychiatry · 2019Article
- Long-Term Violent Reoffending Following Forensic Psychiatric Treatment: Comparing Forensic Psychiatric Examinees and General Offender Controls.Frontiers in psychiatry · 2019Article
- Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data.PloS one · 2019Article
- Selecting a risk assessment tool to use in practice:a 10-point guide.Evidence-based mental health · 2018Review
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundCurrent approaches to assess violence risk in secure hospitals are resource intensive, limited by accuracy and authorship bias and may have reached a performance ceiling. This study seeks to develop scalable predictive models for violent offending following discharge from secure psychiatric hospitals.
methodsWe identified all patients discharged from secure hospitals in Sweden between January 1, 1992 and December 31, 2013. Using multiple Cox regression, pre-specified criminal, sociodemographic, and clinical risk factors were included in a model that was tested for discrimination and calibration in the prediction of violent crime at 12 and 24 months post-discharge. Risk cut-offs were pre-specified at 5% (low vs. medium) and 20% (medium vs. high).
resultsWe identified 2248 patients with 2933 discharges into community settings. We developed a 12-item model with good measures of calibration and discrimination (area under the curve=0.77 at 12 and 24 months). At 24 months post-discharge, using the 5% cut-off, sensitivity was 96% and specificity was 21%. Positive and negative predictive values were 19% and 97%, respectively. Using the 20% cut-off, sensitivity was 55%, specificity 83% and the positive and negative predictive values were 37% and 91%, respectively. The model was used to develop a free online tool (FoVOx).
interpretationWe have developed a prediction score in a Swedish cohort of patients discharged from secure hospitals that can assist in clinical decision-making. Scalable predictive models for violence risk are possible in specific patient groups and can free up clinical time for treatment and management. Further evaluation in other countries is needed.
fundingWellcome Trust (202836/Z/16/Z) and the Swedish Research Council. The funding sources had no involvement in writing of the manuscript or decision to submit or in data collection, analysis or interpretation or any aspect pertinent to the study.
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