The dangerous and severe personality disorder experiment--review of empirical research.
BACKGROUND
A pilot programme for the treatment of individuals with dangerous and severe personality disorder (DSPD) was established in the UK in 2001. A substantial investment had been made into research and evaluation of the initiative, but it is not clear what the outcomes of this research have been.


OBJECTIVE
This study aimed to review empirical research on the DSPD programme.


METHODS
We conducted a systematic literature review by using electronic searches of the databases MEDLINE, PsycINFO and EMBASE, complemented by hand searches of key journals and websites.


RESULTS
We identified a total of 29 empirical research papers and three comprehensive research reports. Most studies were concerned with describing the DSPD population and confirmed that the projects targeted high-risk personality disordered offenders. Qualitative research identified a number of concerns regarding stigma, restrictiveness of the environment and indeterminate detention. Organisational enquiries recognised inefficiencies in assessment and treatment delivery. No high-quality trials were carried out of specific treatments or service environments.


CONCLUSIONS
The key question--what treatments are effective for high-risk personality disordered offenders--remains unanswered. More time would be needed to fully assess the impact of this programme, and similar future initiatives should allow longer observation periods.
Section of Forensic Mental Health, Division of Psychiatry, University of Nottingham, Institute of Mental Health, Innovation Park, Triumph Road, Nottingham,UK. birgit.vollm@nottingham.ac.uk
Birgit
B
Völlm
Nagaraj
N
Konappa
D003617:Dangerous Behavior; D036262:Empirical Research; D006801:Humans; D008605:Mental Health Services / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000175:diagnosis / Q000628:therapy*; D012308:Risk Management; D006113:United Kingdom