Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-19T09:49:58.120Z Has data issue: false hasContentIssue false

Young ‘Psychopaths’ in Special Hospital: Treatment and Outcome

Published online by Cambridge University Press:  02 January 2018

D. Reiss*
Affiliation:
Bethlem-Maudsley Hospital
D. Grubin
Affiliation:
St. Nicholas' Hospital, Newcastle upon Tyne
C. Meux
Affiliation:
Institute of Psychiatry and Broadmoor Hospital
*
Dr David Reiss, Department of Forensic Psychiatry, Institute of Psychiatry, Denmark Hill, London SE5 8AF

Abstract

Background

The ‘Young Persons Unit’ (YPU) at Broadmoor Hospital offers psychotherapeutic treatment for young adult male patients. The study objective was to report background details, treatment and outcome of the ward's personality disordered patients.

Method

The sample consisted of 49 patients, with the legal classification of psychopathic disorder, treated on the unit for at least one year. Data were collected from existing case records. Outcome was recorded until discharge from statutory supervision. Outcome measures were recidivism and a variety of social factors.

Results

At follow-up 10 patients had reoffended, with four having committed serious violent or sexual offences. Two patients had died. A history of sex offending was the strongest predictor of subsequent reoffending. No patients with good social outcome reoffended.

Conclusions

Young patients with personality disorder can be successfully treated on the YPU. The management of sex offenders in this group requires further attention. Successful social integration within the community after discharge may help prevent future reoffending.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acres, D. I. (1975) The aftercare of special hospital patients. In Report of the Committee on Mentally Abnormal Offenders. Cmnd 6244 (Home Office and Department of Health and Social Security), pp. 291302, Appendix 3. London: HMSO.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn revised) (DSM–III–R). Washington, DC: APA.Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Bailey, J. & MacCulloch, M. (1992a) Characteristics of 112 cases discharged directly to the community from a new special hospital and some comparisons of performance. Journal of Forensic Psychiatry, 3, 91112.Google Scholar
Bajley, J. & MacCulloch, M. (1992b) Patterns of reconviction in patients discharged directly to the community from a special hospital: implications for after-care. Journal of Forensic Psychiatry, 3, 445461.Google Scholar
Brett, T. (1992) The Woodstock approach. Criminal Behaviour and Mental Health, 2, 152158.Google Scholar
Cleckley, H. (1976) The Mask of Sanity (5th edn). St. Louis, MO: Mosby.Google Scholar
Coid, J. W. (1992) DSM–III diagnoses in criminal psychopaths: a way forward. Criminal Behaviour and Mental Health, 2, 7894.Google Scholar
Collins, P. (1991) The treatability of psychopaths. Journal of Forensic Psychiatry, 2, 103110.Google Scholar
Cox, M. (1976) Group psychotherapy in a secure setting. Proceedings of the Royal Society of Medicine, 69, 215220.Google Scholar
Dell, S. & Robertson, G. (1988) Sentenced to Hospital. Maudsley Monograph No. 32. Oxford: OUP.Google Scholar
Grounds, A. T., Quayle, M. T., France, J., et al (1987) A ward for ‘Psychopathic disorder’ patients in Broadmoor Hospital. Medicine, Science and the Law, 27, 2131.Google Scholar
Gunn, J. & Robertson, G. (1976) Psychopathic personality: a conceptual problem. Psychological Medicine, 6, 631634.Google Scholar
Hare, R. D. (1991) The Hare Psychopathy Checklist-Revised. Toronto, Ontario: Multi-Health Systems.Google Scholar
Lewis, A. (1974) Psychopathic personality: a most elusive category. Psychological Medicine, 4, 133140.Google Scholar
Norris, M. (1984) Integration of Special Hospital Patients into the Community. London: Gower.Google Scholar
Robertson, G. (1989) Treatment for offender patients: How should success be measured? Medicine, Science and the Law, 29, 303307.Google Scholar
Taylor, P. J. (1992) Introductory note. Criminal Behaviour and Mental Health, 2, iiiv.Google Scholar
Tennent, G. & Way, C. (1984) The English special hospital – A 12–17 year follow-up study: a comparison of violent and nonviolent reoffenders and non-offenders. Medicine. Science and the Law, 24, 8191.Google Scholar
Wong, S. (1988) Is Hare's Psychopathy Checklist reliable without the interview? Psychological Reports, 62, 931934.CrossRefGoogle ScholarPubMed
World Health Organization (1992) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.