title: Value of standard personality assessments in informing clinical decision - making in a medium secure unit.
abstract: BACKGROUND
  Assessing those with personality disorder for treatment in secure settings is known to be unsatisfactory.
  
  
  OBJECTIVE
  To examine the utility of a standardised assessment of offenders with personality disorder referred for treatment in secure care in a naturalistic study.
  
  
  METHODS
  A consecutive series of 89 men were assessed with a battery of four recommended instruments measuring personality and risk. Decisions on whether or not to admit were based on a multidisciplinary discussion informed by these assessments.
  
  
  RESULTS
  Of the 89 comprehensively assessed referrals, 60 (67%) were offered admission. High scores on the Psychopathy Checklist-Revised (especially on Factor 1) was the only measure that was associated with rejection. Of 44 patients discharged, 29 (66%) failed to complete treatment; none of the pre-admission assessments distinguished ;completers' from ;non-completers'. Although skills were acquired on the unit, follow-up of 24 men in the community showed that this had only a marginal effect on re-offending rate (58%).
  
  
  CONCLUSIONS
  Current recommended assessment methods appear unsatisfactory in identifying those who either (a) complete treatment or (b) benefit from treatment. Our results throw doubt on their value.
authors.affiliation: Sction of Fornsic Mental Health, University of Nottingham, UK. conor.duggan@nottshc.nhs.uk
authors.forename: Conor
authors.initials: C
authors.lastname: Duggan
authors.forename: Lauren
authors.initials: L
authors.lastname: Mason
authors.forename: Penny
authors.initials: P
authors.lastname: Banerjee
authors.forename: John
authors.initials: J
authors.lastname: Milton
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003657:Decision Making; D005500:Follow-Up Studies; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010552:Personality Assessment / Q000592:standards*; D010554:Personality Disorders / Q000175:diagnosis* / Q000628:therapy; D011329:Prisoners / Q000331:legislation & jurisprudence / Q000523:psychology*; D012307:Risk Factors; D016896:Treatment Outcome; D016312:Treatment Refusal