Clinical Subgroups of Individuals Receiving Care in a Forensic Hospital: A 20-Year Comparison and Treatment Need Implications.

This study examines whether clinical need subgroups in forensic care have evolved over 20 years and explores differences in adverse childhood experiences (ACEs) and assaultive behaviors across groups. This retrospective observational study used data from a hospital for men; Sample 1 (S1, N = 97) collected in 1990, and Sample 2 (S2, N = 176) in 2009-2012. A data-driven multiple correspondence analysis and a cluster analysis was conducted on S1 based on clinical needs, then applied to S2. ACEs and assault proportions within each cluster were compared using chi-square tests. Clusters identified: minimal needs (S1 = 23%, S2 = 20%); psychotic disorders (S1 = 19%, S2 = 17%); personality disorders (S1 = 21%, S2 = 22%); complex needs (S1 = 37%, S2 = 41%). Participants reporting ACEs (p = .004) and assault (p < .001) differed between clusters. The third cluster reported the highest ACEs (84.6%) and assault (61.5%).