Sex and gender differences in the Italian forensic psychiatric population: a residences for the execution of security measures study

Although sex and gender differences are well-known in psychiatry, their research in the forensic psychiatric population is still limited. This study is aimed at bridging this gap by examining gender-specific factors and treatment needs among forensic psychiatric patients who are highly dangerous. By retrospectively analyzing data from a 1-year observational study on the Italian Residences for the Execution of Security Measures (REMS) patients (n = 730), we compared the main sociodemographic, clinical, and criminological variables between n = 80 female and n = 650 male patients. Female offenders exhibited a higher prevalence of personality (p < 0.001) and depressive disorders (p < 0.001), as well as more severe crimes leading to REMS admission, notably homicide or attempted homicide (p < 0.05). Furthermore, female offenders had a less frequent history of substance abuse (p < 0.001) than male offenders. Despite these differences, there was no evidence of gender-based differences in different sociodemographic and clinical parameters. This study highlights gender differences in forensic psychiatric patients and underscores the importance of nuanced assessment for implementing tailored interventions in forensic psychiatric care.