Coercion in psychiatry is associated mainly with involuntary admissions. The purpose of this study was to investigate the associations between hospital admissions of patients suffering from affective and schizophrenic disorders and seasonality. A systematic literature search using PubMed, Scopus and Google Scholar was conducted, including studies with affective and schizophrenia disorder admissions, published from October 1992 to August 2020. A total of 31 studies were included in the review. Four broad severe mental illness admission categories were identified regarding seasonality: affective disorders, schizophrenia disorders, involuntary admission affective disorders and involuntary admission schizophrenia disorders. There was clear and strong evidence for spring and summer peaks for severe mental illness admissions; data provided for age, gender and involuntary admissions was limited. Seasonality may have a significant effect on the onset and exacerbation of psychopathology of severe mental illness and should be considered as a risk factor in psychiatric admissions, violence and the risk of mental health coercion. A better understanding of the impact of seasonality on severe mental illness will help professionals to provide the best practices in mental health services in order to reduce and prevent psychiatric hospitalizations (especially involuntary admissions) resulting in further coercive measures.

The risk for general or criminal recidivism in forensic psychiatric patients has not been extensively investigated in the literature. The aim of this review is to evaluate criminal recidivism among forensic patients with mental disorders undergoing some type of outpatient treatment. In this review, we utilized PubMed, Embase, Scopus, and the Cochrane Library to search for studies published from January 1990 up to July 2024. Eligible studies should i) evaluate forensic patients with mental health conditions, ii) evaluate patients undergoing outpatient treatment, and iii) evaluate criminal recidivism (general, sexual, or violent) as a primary outcome. Recidivism was also compared between groups when reported. Overall, 12 clinical studies including 3271 patients were evaluated. Of these, 3048 patients undergoing outpatient treatment were analyzed. The mean age of all patients was 23.4 years (SD = 6.3), and 79.7 %. were male. The mean follow-up was 33.82 months. Overall, the pooled proportion for general recidivism was 39.1 % (95 % CI: 25 %-54.3 %), and for violent recidivism was 21.7 % (95 % CI: 2.6 %-52.3 %; data from four studies). In group comparisons (data from five studies), there was no difference between patients under treatment and the control groups as far as general recidivism (OR = 0.489; 95 % CI [0.202-1.183]; P = 0.112), and violent recidivism (OR = 0.283; 95 % CI [0.056-1.416]; P = 0.124) were concerned. The general and violent recidivism rates are high among forensic patients undergoing outpatient treatment for mental health disorders. There was no difference between outpatient treatment and control groups regarding their effect on recidivism. However, most of the studies reviewed did not provide information about drug treatment; more comparative studies focusing on pharmacotherapy are needed to verify any benefits of outpatient treatment.

Forensic psychiatric patients often present with severe psychopathology, functional impairment, and poor quality of life. Longitudinal follow‐up studies in forensic psychiatric outpatient populations remain limited. The objective is to assess psychopathology, quality of life, global functioning, and general health in forensic psychiatric outpatients compared with psychiatric patients without a forensic history over 24 months. A prospective longitudinal study was conducted with 120 participants (63 forensic and 57 psychiatric outpatients). Assessments were conducted at baseline, 6, 12, and 24 months using validate psychometric tools, PANSS, GHQ‐28, WHOQOL‐BREF, and GAF. Longitudinal changes within and between groups were analyzed. Most participants were male (82.5%), single (64.2%), unemployed (72.3%), and living in urban areas (93.3%). Forensic psychiatric outpatients reported less social support than psychiatric patients (68.3% vs. 89.5%). Most had a history of incarceration (93.8%). Schizophrenia was the predominant diagnosis (98.3%). Psychopathology, functioning, quality of life, and general health improved significantly over time in both groups ( p < 0.001). Positive symptoms improved more in psychiatric patients (mean change −8.96). Psychiatric patients scored significantly higher in the WHOQOL‐BREF “environment” domain at baseline and at 6 months. Greater improvement in anxiety/insomnia symptoms was observed in psychiatric patients (mean change −6.44). Long‐term outpatient psychiatric follow‐up was associated with significant improvements in symptom severity, functioning, quality of life, and general health in both groups. However, forensic psychiatric outpatients continued to experience greater disadvantages, highlighting the need for tailored, long‐term, community‐based interventions in forensic mental health care.

Precision psychiatry promises a more objective and effective approach to psychiatric care, yet its implementation raises growing ethical challenges as technology advances. This narrative review offers a qualitative synthesis of the ethical issues reported in 62 studies, with emphasis on the practical tensions that arise when core principles conflict. Rather than organising concerns around traditional ethical principles, the review maps them across the main modalities of precision psychiatry, namely genomics, neuroimaging, digital phenotyping, and AI-driven interventions. Four explicit positions are advanced. First, equity must be engineered from the outset rather than assumed. Second, interpretability should outweigh marginal gains in accuracy in a field built on subjective report. Third, stigma is bidirectional and contingent on framing and the availability of meaningful intervention. Fourth, individualised care must demonstrate clinical and economic superiority over standardised approaches. Precision psychiatry is likely to reshape psychiatric practice and the therapeutic relationship itself. Interdisciplinary collaboration, clear guidelines, and continuous ethical vigilance will be essential for responsible adoption and sustained public trust.