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Objectives: To evaluate factors related to dangerousness cessation at the end of involuntary commitment based on an analysis of expert reports. In light of the current legal requirement of dangerousness cessation as a pre-requisite for prison or internment release of individuals subjected to the safety measure, we sought elements to reflect on the practice of expert examiners in charge of making this decision. Methods: The authors revised 224 expert psychiatric dangerousness cessation reports released 2011 through 2014 and collected data for a statistical analysis. Results: The following variables were associated with positive risk cessation assessments: no inadequate behavior (according to the assistant professionals), no productive psychotic symptoms, no negative symptoms, presence of insight, presence of a support network, and no psychoactive substance abuse. The following variables were associated with negative dangerousness cessation decisions: early onset of malfunction, lack of insight, negative attitudes, active signs of major mental illness, presence of impulsiveness, poor response to treatment, presence of plans lacking feasibility, exposure to destabilizing factors, lack of personal support, and presence of stress. Conclusions: In this study we were able to identify factors associated with dangerousness in a sample of expert reports. The knowledge of factors linked to a higher risk of recidivism in illegal activities or violent behavior is crucial for decision-making regarding the release of offenders after their legally established period of involuntary commitment.

Objective: This preliminary study aimed to identify and compare characteristics related to violent behavior in inpatients with schizophrenia at a general psychiatric hospital using the Historical, Clinical, and Risk Management 20 (HCR-20), the Modified Overt Aggression Scale (MOAS), and sociodemographic data. Method: Violent and nonviolent participants were selected based on psychiatric admission reports. Participants with reports of aggressive behavior and HCR-20 total score ≥ 21 upon admission were assigned to the violent patient group. Participants without aggressive behavior and with HCR-20 total score < 21 upon admission were assigned to the nonviolent patient group. The MOAS was applied to characterize the degree of severity of the violent behavior. Results: HCR-20 and its subscales were effective in differentiating between the violent and nonviolent participant groups. Twelve of the 20 HCR-20 items were useful for distinguishing between the groups, although total HCR-20 scores were more reliable when applied to the nonviolent patient group. The MOAS did not show high degrees of severity for the types of aggression observed in the participants. Conclusion: HCR-20 was useful and reliable for distinguishing between violent and nonviolent patients with schizophrenia in this clinical psychiatric setting. Item analysis identified the most relevant characteristics in each group. The use of the HCR-20 in clinical psychiatric settings should be encouraged.

A violência é globalmente reconhecida como um problema de saúde pública. Em 2002, a Organização Mundial da Saúde (OMS) deu destaque para o abuso e para a negligência por seu caráter crônico e pelos danos psicológicos, sociais e injúria física que geram, sendo as crianças frequentemente vitimizadas. Este artigo apresenta os diferentes tipos de maus-tratos infantis, com enfoque principal na síndrome de Munchausen por procuração, visto apresentar a característica peculiar de envolver três entidades, mesmo que de forma inadvertida: o médico, o cuidador/perpetrador e a criança/vítima.

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