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A standardised tool for assessing needs in forensic psychiatric population: clinical validation of the Italian CANFOR, staff version

  • L. Castelletti (a1), A. Lasalvia (a2), E. Molinari (a1), S. D. M. Thomas (a3), E. Straticò (a1) and C. Bonetto (a2)...



The Camberwell Assessment of Need – Forensic Version (CANFOR) is a standardised assessment tool specifically designed to assess needs for care in forensic psychiatric populations. The original English version of the instrument has shown good psychometric properties. The aim of this study was to validate the Italian version of the CANFOR-staff tool.


After translation and back-translation, the Italian CANFOR tool was administered to a sample of 50 forensic psychiatric patients. Convergent validity was tested using the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF) by applying Kendall's tau-b. Inter-rater and test–retest reliabilities were measured by ICCs for need dimensions (total and unmet) and Cohen's kappa coefficients for individual need items.


Regarding convergent validity, a higher number of needs (total and unmet) were associated with more severe psychiatric symptoms (BPRS). Higher numbers of unmet needs were also associated with lower levels of global functioning (GAF). ICCs for total and unmet needs scores indicated a good level of agreement for inter-rater reliability and a very good level for test–retest, respectively. Regarding the specific items, inter-rater Cohen's kappa was high (moderate to very good agreement) for 18 items in relation to the presence of a need and for 15 items in the rating of an unmet need, whereas Cohen's kappa for test–retest reliability was very high for all the items in the presence of a need and high for 18 of the unmet need domains.


The Italian version of CANFOR has adequate psychometric properties. It can be considered a promising instrument for the assessment of needs of forensic psychiatric patients.


Corresponding author

* Address for correspondence: Dr Luca Castelletti, Ospedale Psichiatrico Giudiziario, località Ghisiola, 46043, Castiglione delle Stiviere (MN), Italy.  (Email:


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