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S08-01 - Cochrane Reviews of Pharmacological and Psychological Interventions for Antisocial Personality Disorder (ASPD)

Published online by Cambridge University Press:  17 April 2020

B. Vollm ,
S. Gibbon ,
N. Khalifa ,
C. Duggan ,
J. Stoffers ,
N. Huband ,
M. Ferriter  and
K. Lieb
B. Vollm
Affiliation:
Section of Forensic Psychiatry, University of Nottingham, Nottingham, UK
S. Gibbon
Affiliation:
Section of Forensic Psychiatry, University of Nottingham, Nottingham, UK
N. Khalifa
Affiliation:
Section of Forensic Psychiatry, University of Nottingham, Nottingham, UK
C. Duggan
Affiliation:
Section of Forensic Psychiatry, University of Nottingham, Nottingham, UK
J. Stoffers
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg im Breisgau, Germany
N. Huband
Affiliation:
Section of Forensic Psychiatry, University of Nottingham, Nottingham, UK
M. Ferriter
Affiliation:
Literature and Evidence Unit, Institute of Mental Health, Woodbeck, UK
K. Lieb
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany

Abstract

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Introduction

ASPD has a prevalence of 2-3% in the general population but rates in prison have been reported as 50% to 75%. ASPD is associated with significant psychiatric and medical comorbidity, high offending rates, poor psychosocial adaptation and premature death. Outcomes are poor. There is little consensus regarding the most effective intervention for the condition.

Aims and objectives

To conduct systematic literature reviews to identify randomised controlled trials for either pharmacological or psychological interventions for ASPD.

Methods

Systematic literature reviews (Cochrane reviews).

Results

For the review on psychological interventions only 11 studies could be included with a total of 411 participants, but only five reported data separately for the subgroup of ASPD. Nine of the studies looked at participants with substance misuse problems who also suffered from ASPD. Only three types of interventions were effective (contingency management, CBT and a specific programme for those convicted for driving whilst intoxicated). These interventions showed positive results for substance misuse related outcomes but not for any others behaviours or symptoms. For the pharmacological review 10 studies were identified, anticonvulsants were the most commonly used drugs with some evidence of effectiveness on aggression, however, study quality was poor.

Conclusions

Despite the considerable personal and societal consequences of ASPD, very little research is carried out with regards to interventions in this patient group and subsequently the evidence base to support any interventions is extremely limited.

Type
Similarities and Differences Among Current Practice Guidelines in the Field of Personality Disorders
Information
European Psychiatry , Volume 25 , Issue S1: 18th European Congress of Psychiatry. February 27, March 2, 2010 - Munich, Germany , 2010 , 25-E90
Copyright
Copyright © European Psychiatric Association 2010
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