Identification of risk and protective factors for violent behavior in a population of psychiatric forensic offenders in southern Italy (RISKMON)

Violence among individuals with severe mental disorders represents a complex and multifactorial phenomenon that continues to challenge forensic mental health systems internationally. Within the Italian post-reform forensic psychiatric system, based on community-oriented care following the closure of judicial psychiatric hospitals, the identification of risk and protective factors associated with violent behavior has become increasingly relevant for clinical management and rehabilitation planning. The present study reports preliminary findings from the RISKMON project, a multicenter longitudinal observational study conducted across forensic psychiatric services in Southern Italy. A total of 126 participants, including forensic and non-forensic psychiatric patients, underwent structured clinical and forensic assessment using standardized instruments evaluating psychopathology, psychopathy, violence risk, aggressive behavior and protective factors. Forensic patients showed poorer global functioning, greater psychopathological severity, higher psychopathy scores and higher structured violence risk compared with non-forensic patients, while differences in protective factors appeared less robust after adjustment for sex, despite comparable demographic and cognitive characteristics. Personality disorders were associated with higher psychopathy scores, while substance use disorders were associated with shorter illness duration and better baseline functioning. The findings support the importance of multidimensional approaches integrating both risk and protective factors in violence risk assessment and forensic rehabilitation planning within forensic settings.