Interpersonal Trauma, Gender, and Psychiatric Symptom Severity: Insights from Forensic Psychiatric Inpatient Data in Ontario, Canada

Forensic mental health treatment represents a specialized form of care aimed at stabilizing psychiatric illness, reducing hospital readmission risk, and supporting reintegration into the community. Various factors are consistently associated with forensic mental health and treatment planning. One relevant factor is exposure to an interpersonal potentially traumatic event (PTE), which is common among forensic inpatients. We analyzed data from 5,105 forensic hospital admissions in Ontario, Canada, between 2013 and 2023, examining whether exposure to sexual, physical, and/or emotional abuse relates to psychiatric symptom severity (i.e., aggression, positive symptoms, depressed mood, and manic symptoms). After accounting for confounding factors (age, gender, education), any exposure to PTE was associated with increased severity of positive symptoms, depressed mood, and manic symptoms, but not aggressive behavior. Timing of PTE exposure (within 1 year versus more than 1 year ago) did not relate to outcomes. Effects were more pronounced among sufferers of polytrauma, highlighting the cumulative burden of PTE exposure. PTE exposure was related to greater symptom severity in men and women, but it was associated with aggression and higher symptom severity in cases of polytrauma among women only. These findings underscore the importance of trauma-informed care and gender-responsive approaches in forensic mental health services.