Tottori J. Clin. Res. 7(1), 64-69, 2016

The participation of dietitians in a multi-disciplinary forensic psychiatric teamtreating mentally ill offenders under the Medical Treatmentand Supervision Act: Case report
Koichi Higashi1,2)*, Yoshinori Kitagawa1,3), Yusuke Kawai1,3), Toyoharu Tsutsumi1,4), Shizu Fukuyasu1,4),
Tomohide Tsunekane1,5), Takashi Takaoka1,6), Shoichiro Minami1,6), Tsuruhei Sukegawa1,7)1) Multi-disciplinary team (MDT), NHO Tottori Medical Center
2) Unit of Nutrition Management, NHO Tottori Medical Center3) Department of Nursing, NHO Tottori Medical Center
4) Regional Medical Liaison Office, NHO Tottori Medical Center5) Clinical Psychology Section, NHO Tottori Medical Center6) Department of Rehabilitation, NHO Tottori Medical Center
7) Department of Psychiatry, NHO Tottori Medical Center*Correspondence: 876 Mitsu, Tottori, 689-0203, JapanAbstract
Hospital A provides mentally ill offenders admitted under the Medical Treatment and Supervision Actwith appropriate medical care and treatment to facilitate their reintegration into society. Treatment programs
are conducted on the forensic psychiatric ward designated under the act by a multi-disciplinary specialist team(forensic psychiatric MDT) from admission to discharge or transfer. In the course of their treatment, somepatients develop lifestyle-related diseases, such as overweightness, dyslipidemia, hypertension, and diabetes,due to unhealthy lifestyle habits. This report describes a schizophrenic patient with lifestyle-related disease
conditions whose eating habits, body weight, and triglyceride levels improved after receiving nutritional
intervention led by national registered dietitians participating in the forensic psychiatric MDT. Tottori J. Clin.
Res. 7(1), 64-69, 2016
Keywords: forensic psychiatric ward designated under the Medical Treatment and Supervision Act, multidisciplinary specialist team, schizophrenia, national registered dietitian, lifestyle-related diseases
Despite this, the role of dietitians in the programs
was limited to providing group nutrition education
sessions several times a year. We present a patientwith lifestyle-related disease conditions whose eating
habits, body weight (BW), and triglyceride (TG)levels improved with regular dietary management bydietitians participating in the forensic psychiatricMDT.

Introduction
As an inpatient medical care facility designatedunder the Medical Treatment and Supervision Act,
Hospital A provides mentally ill offenders admitted
to the forensic psychiatric ward under the act withappropriate medical care and treatment to facilitate
their reintegration into society1). After admission,
patients undergo various treatment programs
conducted by the forensic psychiatric MDT in a
stepwise manner, from acute to recovery and then to
rehabilitation stages, until they are discharged ortransferred. In the course of their treatment, a
number of patients develop lifestyle-related diseases,
such as overweightness, dyslipidemia, hypertension,and diabetes, due to unhealthy lifestyle habits,
including increased snacking and lack of exercise.

Patient
A 30-year-old man (height, 168.5 cm; BW,100.4 kg; and BMI, 35.4 kg/m2 at admission) wasdiagnosed with schizophrenia and received
medication at a local clinic around the year 200X. He
was noted to have hyperglycemia and fatty liver atthat time. In the Y-th month of the year 200X + 4, he1