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Research ArticleRegular Article

Long-Term Competence Restoration

Douglas R. Morris and Nathaniel J. DeYoung
Journal of the American Academy of Psychiatry and the Law Online March 2014, 42 (1) 81-90;
Douglas R. Morris
Dr. Morris is Clinical Service Line Director, Isaac Ray Treatment Center, Logansport State Hospital, Logansport, IN, and Volunteer Clinical Assistant Professor of Psychiatry, Indiana University School of Medicine, Indianapolis, IN. Dr. DeYoung is a Neuropsychology Fellow, Department of Psychological Sciences, Purdue University, West Lafayette, IN.
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Nathaniel J. DeYoung
Dr. Morris is Clinical Service Line Director, Isaac Ray Treatment Center, Logansport State Hospital, Logansport, IN, and Volunteer Clinical Assistant Professor of Psychiatry, Indiana University School of Medicine, Indianapolis, IN. Dr. DeYoung is a Neuropsychology Fellow, Department of Psychological Sciences, Purdue University, West Lafayette, IN.
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    Figure 1.

    Disposition of subjects who were not restored after six months of restoration efforts. *Subjects whose charges were dismissed during their hospitalizations continued their hospitalizations under their civil commitments and were eligible to progress through less-restrictive settings to eventual community discharge.

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    Figure 2.

    Cumulative restoration success over time for incompetent defendants who were not restored during six months of restoration efforts. During the study period (through December 31, 2012), all but two subjects were either hospitalized for longer than 5.5 years or reached final disposition of their legal charges. The two subjects remaining IST and hospitalized for less than 5.5 years were hospitalized for 3.77 and 4.10 years at study's end. These subjects may increase the total number of subjects eventually restored and successfully adjudicated.

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    Table 1.

    Cumulative Restoration and Restoration With Successful Adjudication

    Time to Restoration (y)RestoredRestored and Successfully Adjudicated
    nCumulative %nCumulative %
    0.5–1.01822.21619.8
    1.0–1.51338.31234.6
    1.5–2.0848.1743.2
    2.0–2.5554.3549.2
    2.5–3.0459.3353.1
    >3.0*464.2154.3
    • ↵* Four subjects were eventually restored to competency after three years of restoration efforts. The lengths of their hospitalizations until successful restoration were 3.13, 3.39, 4.72, and 5.32 years. Only one of these (3.39 years) proceeded to successful adjudication.

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    Table 2.

    Likelihood of Future Restoration and Restoration With Successful Adjudication After Years of Restoration Efforts

    Duration of Restoration Efforts (y)Subsequently RestoredSubsequently Restored and Successfully Adjudicated
    n%n%
    1.03454.02843.8
    1.52142.01630.2
    2.01331.0919.6
    2.5821.649.8
    3.0412.112.6
    • “Subsequently Restored and Successfully Adjudicated” refers to the number and percentage of subjects who would eventually achieve successful restoration and restoration with adjudication after a set period. For example, 34 (54.0%) of the 63 subjects not yet restored by one year eventually achieved successful restoration. Beyond one year of restoration efforts, 28 (43.8%) of the 65 unrestored (or restored but with failure of adjudication) subjects would eventually progress to successful restoration and adjudication.

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Journal of the American Academy of Psychiatry and the Law Online: 42 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 42, Issue 1
1 Mar 2014
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Long-Term Competence Restoration
Douglas R. Morris, Nathaniel J. DeYoung
Journal of the American Academy of Psychiatry and the Law Online Mar 2014, 42 (1) 81-90;

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Douglas R. Morris, Nathaniel J. DeYoung
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