Hospitalized insanity acquittees' level of functioning.
P. J. Shah, W. M. Greenberg and A. Convit,
Bull. Amer. Acad. Psychiatry & the Law
22(1): 85-93, 1994.
Since 1975 in New Jersey, similar legal criteria apply to the discharge of insanity acquittees as those
patients who are civilly committed. Based on contact with insanity acquittees (NGRIs) in a regional
state hospital, we had the impression that they appeared to be functioning better than the general
inpatient population. The purpose of this study was to assess the length of inpatient stay and the level
of functioning for the NGRIs and contrast it to a comparison group selected to for variables such as
age, ethnicity, Axis I diagnosis, and history of substance abuse, which could impact on our variables
of interest. We obtained psychiatrist-rated clinical global impression (CGI) scores and nursing-rated
specific level of functioning (SLOF) scores in a group of 62 NGRIs and in a matched group of 62
controls. The NGRIs had significantly better CGI scores, and higher "personal care skills" and
"social acceptability" SLOF section scores. The social acceptability subscale includes items for
aggressiveness towards others, self, and property, all of which were significantly better for the
NGRIs. Thus, in our setting, inpatient NGRIs displayed some evidence of better clinical functioning,
including less perceived aggressiveness, than the control inpatients. Although the NGRIs has been
in the regional state hospital for a shorter period than the controls, the NGRIs had spent an average
of over three continuous years in secure facilities before transfer to the regional state hospital. We
discuss our findings in view of high rates of paranoid subtypes of psychotic disorders among the
NGRI group, and the high prevalence of substance abuse.