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Research ArticleRegular Articles

Characteristics of Misdemeanants Treated for Competency Restoration

Artha Gillis, Brian Holoyda, William J. Newman, Machelle D. Wilson and Glen L. Xiong
Journal of the American Academy of Psychiatry and the Law Online December 2016, 44 (4) 442-450;
Artha Gillis
Dr. Gillis is a Fellow in Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA. Dr. Holoyda is a Resident in Psychiatry, Dr. Xiong is an Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, and Dr. Wilson is a Senior Statistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Sacramento, CA. Dr. Newman is an Associate Professor of Psychiatry, Department of Psychiatry, Saint Louis University, St. Louis, MO. The project was supported in part by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH) Grant UL1 TR000002.
MD, PhD
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Brian Holoyda
Dr. Gillis is a Fellow in Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA. Dr. Holoyda is a Resident in Psychiatry, Dr. Xiong is an Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, and Dr. Wilson is a Senior Statistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Sacramento, CA. Dr. Newman is an Associate Professor of Psychiatry, Department of Psychiatry, Saint Louis University, St. Louis, MO. The project was supported in part by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH) Grant UL1 TR000002.
MD, MPH
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William J. Newman
Dr. Gillis is a Fellow in Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA. Dr. Holoyda is a Resident in Psychiatry, Dr. Xiong is an Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, and Dr. Wilson is a Senior Statistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Sacramento, CA. Dr. Newman is an Associate Professor of Psychiatry, Department of Psychiatry, Saint Louis University, St. Louis, MO. The project was supported in part by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH) Grant UL1 TR000002.
MD
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Machelle D. Wilson
Dr. Gillis is a Fellow in Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA. Dr. Holoyda is a Resident in Psychiatry, Dr. Xiong is an Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, and Dr. Wilson is a Senior Statistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Sacramento, CA. Dr. Newman is an Associate Professor of Psychiatry, Department of Psychiatry, Saint Louis University, St. Louis, MO. The project was supported in part by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH) Grant UL1 TR000002.
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Glen L. Xiong
Dr. Gillis is a Fellow in Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA. Dr. Holoyda is a Resident in Psychiatry, Dr. Xiong is an Associate Professor of Psychiatry, Department of Psychiatry and Behavioral Sciences, and Dr. Wilson is a Senior Statistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Sacramento, CA. Dr. Newman is an Associate Professor of Psychiatry, Department of Psychiatry, Saint Louis University, St. Louis, MO. The project was supported in part by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH) Grant UL1 TR000002.
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    Figure 1.

    Selection of misdemeanants treated for competency restoration for inclusion in the data analysis.

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    Table 1

    Demographic Characterics

    CharacteristicRestored (n = 152)Not Restored (n = 69)Test Statisticp
    Sex
        Male109 (71)54 (78)χ2 = 1.052 (df = 1)0.305
        Female43 (29)15 (22)
    Age
        Mean ± SD41.68 ± 12.8142.64 ± 13.84t = 0.503 (df = 219)0.615
        Range19.1–77.920.7–84.7
    Ethnicity
        Caucasian63 (45)30 (45)χ2 = 0.001 (df = 1)0.976
        Non-Caucasian77 (55)37 (55)
            Black/African-American43 (28)17 (25)
            Hispanic11 (7)8 (12)
            Asian12 (8)4 (6)
            Other11 (7)8 (12)
    Marital Status
        Single/never married96 (69)58 (85)χ2 = 6.659 (df = 1)0.010
        Married, divorced, separated or widowed44 (31)10 (15)
    Primary language
        English-speaking140 (92)64 (95)χ2 = 0.851 (df = 1)0.356
        Non-English-speaking12 (8)3 (5)
    Educational status
        Finished high school94 (68)43 (72)χ2 = 0.247 (df = 1)0.619
        Did not finish high school44 (32)17 (28)
    Employment status
        Employed/volunteer/student/retired136 (90)61 (88)χ2 = 0.056 (df = 1)0.813
        Unemployed16 (10)8 (12)
    • Unless otherwise specified, the data are expressed as the number (percentage of the total group). The characteristics are those of misdemeanor defendants undergoing restoration of competence to stand trial during 221 hospital admissions. Shown is the performance of each characteristic as a determinant of restoration.

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    Table 2

    Clinical Characteristics

    CharacteristicRestored (n = 152)Not Restored (n = 69)Test Statisticp
    Episode (mean ± SD)16.49 ± 19.2414.71 ± 15.53t = −0.676 (df = 219)0.500
    Length of stay (mean in days ± SD)20.29 ± 12.5232.14 ± 20.17t = 5.334<0.001
    Global assessment functioning (mean ± SD)49.71 ± 6.8839.43 ± 8.24t = −9.543 (df = 215)<0.001
    Previous inpatient admission(s) (mean ± SD)4.01 ± 5.834.30 ± 5.75t = 0.3530.724
    Cumulative length of stay (mean in days ± SD)*96.22 ± 181.29129.57 ± 184.63t = 1.260 (df = 219)0.209
    Insurance status
        Medicare/Medicaid31 (44)6 (33)χ2 = 0.705 (df = 1)0.401
        County-insured (indigent)39 (56)12 (67)
    Outpatient linkage
        Linked with outpatient provider PTA29 (19)9 (13)χ2 = 1.214 (df = 1)0.271
        Not linked with outpatient provider PTA123 (81)60 (87)
    Clinical syndrome
        Psychotic disorder104 (68)62 (90)χ2 = 12.588 (df = 1)<0.001
        Mood disorder39 (25)4 (6)χ2 = 12.588 (df = 1)<0.001
            Bipolar disorder34 (22)3 (4)χ2 = 9.935 (df = 1)0.002
            Major or minor depression4 (3)1 (1)χ2 = 1.381 (df = 1)0.240
        Anxiety disorder7 (5)0 (0)χ2 = 3.414 (df = 1)0.065
        Substance use disorder47 (31)16 (23)χ2 = 1.812 (df = 1)0.178
        Cognitive disorder5 (3)7 (10)χ2 = 2.667 (df = 1)0.102
    Pharmacotherapy
        Oral antipsychotic medication140 (92)63 (91)χ2 = 0.041 (df = 1)0.840
        Long-acting injectable antipsychotic medication8 (5)5 (7)χ2 = 0.337 (df = 1)0.561
        Mood stabilizing medication67 (44)24 (35)χ2 = 1.693 (df = 1)0.193
        Antidepressant medication16 (11)2 (3)χ2 = 3.691 (df = 1)0.055
        Anxiolytic medication19 (13)4 (6)χ2 = 2.287 (df = 1)0.130
        Anticholinergic medication27 (18)11 (16)χ2 = 0.111 (df = 1)0.740
    • Unless otherwise specified, data are expressed as the number (percentage of the total group). The characteristics are those of misdemeanor defendants undergoing restoration of competence to stand trial during 221 hospital admissions. Shown is the performance of each characteristic as a determinant of restoration.

    • ↵* Cumulative length of stay for each defendant as the sum of all days that the defendant spent in an inpatient psychiatric setting across all hospital admissions.

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    Table 3

    Forensic Characteristics

    CharacteristicRestored (n = 152)Not Restored (n = 69)Test Statisticp
    Type of charges
        Violent charges47 (31)30 (44)χ2 = 3.296 (df = 1)0.069
        Nonviolent charges121 (80)48 (70)χ2 = 2.659 (df = 1)0.103
        Sexual charges30 (20)15 (22)χ2 = 0.117 (df = 1)0.732
    Total charges (mean ± SD)2.72 ± 2.332.64 ± 1.94t = −0.246 (df = 219)0.806
    Forced-medication order75 (50)24 (36)χ2 = 3.590 (df = 1)0.058
    Forced-medication order (after 2008)74 (69)24 (65)χ2 = 0.233 (df = 1)0.629
    Previous restoration attempt (mean ± SD)0.10 ± 0.320.20 ± 0.53t = 1.804 (df = 219)0.073
    Outcome of previous restoration attempt (14 restored, 11 nonrestored)
        Restored12 (86)5 (46)χ2 = 4.588 (df = 1)0.032
        Not restored2 (14)6 (54)
    • Unless otherwise specified, data are expressed as the number (percentage of the total group). The characteristics are those of misdemeanor defendants undergoing restoration of competence to stand trial during 221 hospital admissions. Shown is the performance of each characteristic as a determinant of restoration.

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Journal of the American Academy of Psychiatry and the Law Online: 44 (4)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 44, Issue 4
1 Dec 2016
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Characteristics of Misdemeanants Treated for Competency Restoration
Artha Gillis, Brian Holoyda, William J. Newman, Machelle D. Wilson, Glen L. Xiong
Journal of the American Academy of Psychiatry and the Law Online Dec 2016, 44 (4) 442-450;

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Characteristics of Misdemeanants Treated for Competency Restoration
Artha Gillis, Brian Holoyda, William J. Newman, Machelle D. Wilson, Glen L. Xiong
Journal of the American Academy of Psychiatry and the Law Online Dec 2016, 44 (4) 442-450;
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