[Personalised medicine in forensic psychiatry: an example for other domains of psychiatry?]

BACKGROUND: Personalised medicine promises to provide us with a diagnostic predictive system of stratification that is based on a wide variety of tests; these can include biological, cognitive, demographic, psychopathological tests and other clearly defined tests. The purpose of forensic psychiatry is not only to take care of and treat mentally impaired patients but also to engage in risk assessment and risk management.<br/> AIM: To explain risk assessment in forensic psychiatry as a nomothetic approach to personalised medicine, and also to demonstrate the link with offence paralleling behaviour, which is an illustration of the ideographic approach.<br/> METHOD: A discussion of recent literature and insights into risk assessment, risk management and offence paralleling behaviour.<br/> RESULTS: Risk assessment helps us to divide patients into groups according to the risk of recidivism. The nomothetic concept is the basis of most risk assessment instruments. One of the most important tasks in risk management in forensic psychiatry is to reduce the risk factors and strengthen the influence of protective factors. The model of offence paralleling behaviour resembles in many respects the concept of integrating risk management and treatment, but shows more precisely how hypotheses can be tested in a clinical context.<br/> CONCLUSION: In view of the great importance to society of preventing offences, forensic psychiatry is leading the way in the application of personalised medicine in psychiatry.