Who should take responsibility for antisocial personality disorder?

BMJ 1999;318:206-207 ( 23 January )

Editorials

Who should take responsibility for antisocial personality disorder?

Fallon suggests emphasising custody, but psychiatrists' future role remains unclear

News p 211 and Personal view p 271

The first 150 words of the full text of this article appear below.

The diagnostic boundaries and treatability of personality disorders have always been medically controversial. Whether offenderswith antisocial¹ or dissocial² personality disorder $---$ "a mostelusive category [with] wavering confines"³ $---$ should be treatedin hospital or punished in prison is profoundly controversial.Now, because of highly publicised cases of paedophilic violentoffenders released from prison and the case of Michael Stone,a convicted psychopathic murderer, the medical response to personalitydisorder has become a subject of national political debate. Thedispute between the home secretary⁴ and the president of theRoyal College of Psychiatrists⁵ about whether psychiatristsshould be preventively detaining untreatable psychopaths underthe Mental Health Act illustrates well the field of politicalconflict.

Into this debate comes the Fallon inquiry into the personality disorder unit at Ashworth high security hospital.⁶ Thiswill soon be followed by the announcement of government policyon future services and legal provisions for personality disordered. . . [Full text of this article]

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Rapid Responses:

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Fallon report will lead to an increase in psychiatrists role in personality disorder: Adrian Warnock
bmj.com, 24 Jan 1999 [Full text]
Treatability of personality disorder: P V F Cosgrove
bmj.com, 27 Jan 1999 [Full text]
Dangerousness, preventative detention and psychiatry: Frank Holloway
bmj.com, 7 Feb 1999 [Full text]
Antisocial personality disorder- Psychiatrist's role in management: Dr.Kommu John Vijay sagar, et al.
bmj.com, 28 Nov 2002 [Full text]