185 Summary and General discussion 7 explored. Data from 102 forensic outpatients randomly allocated to either TAU with the addition of FNC or TAU alone was included in the statistical analyses. The results demonstrated no significant differences between FNC plus TAU and TAU alone on mental wellbeing. However, significant benefits of FNC plus TAU were found on hospitalization duration and criminal behavior with no evidence of dose-response effects. Explorative analyses showed that treatment effects were moderated by sex, substance use disorders, and comorbidity. We concluded that although there were no benefits for mental wellbeing and most other treatment outcomes, the positive effects on hospitalization duration and criminal behavior indicated that usual care of forensic psychiatric outpatients could be improved by the addition of an informal social network intervention. Furthermore, we emphasized that future research is warranted to explore which patients might benefit from these interventions and how treatment effects can be further improved. Lastly, in chapter 6 we described the impact of the COVID-19 restrictions on social relationships of forensic psychiatric outpatients. First, we explored whether patients were dissatisfied with the quality of social relationships before the onset of the restrictions. Second, we explored whether (a) the quality of social relationship deteriorated due to the restrictions and (b) whether the quality of social relationships deteriorated over time. Third, we examined if loneliness and social support would predict negative changes in social relationships due to the restrictions.We analyzed baseline and follow-up assessments of 70 forensic outpatients participating in the aforementioned RCT during the COVID-19 pandemic using a mixed methods design. We demonstrated that feelings of dissatisfaction with the quality of social relationships, loneliness, and negative social support were already evident in forensic outpatients before onset of the COVID-19 restrictions. Except for family relationships that slightly deteriorated over time, the results showed that the majority of forensic outpatients perceived no changes in social relationships due to the restrictions, as well as no changes over time. Qualitative results suggested that the absence of changes could be related to the fact that social network problems, such as social isolation and avoidant attitudes towards others, were already reported before the restrictions. In addition, we found that emotional loneliness predicted more negative changes in general social relationships and romantic relationships of forensic outpatients due to the restrictions. We emphasized that social relationships of forensic outpatients with preexisting social network problems remained of concern throughout the COVID-19 pandemic. Furthermore, we suggested that interventions focusing on the development and maintenance of social bonds, in particular among forensic psychiatric outpatients with higher levels of emotional loneliness, could be important in future times of pandemics.
RkJQdWJsaXNoZXIy MjY0ODMw