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Randomised controlled trials relevant to aggressive and violent people, 1955-2000: a survey

GenCertHort, Sainsbury Library, Said Business School, Oxford

Wan Lian Chua, BMedSci, BMBS, MRCPsych

Airedale General Hospital, Keighley

Lorna Duggan, MBCh B, MRCPsych

St Andrew’s Hospital, Northampton

Clive Adams, MBCh B, BAO, MRCPsych, MSci(Epid), MD

Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK

Correspondence: Professor Clive Adams, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK.Tel: +44 (0)113 343 2730;fax: +44 (0)113 343 2723; e-mail: ceadams{at}cochrane-sz.org

Declaration of interest None.

Background Randomised trials remain the gold standard for evaluating health interventions. This applies to the criminal justice system as well as to health.

Aims To identify and survey randomised trials relevant to forensic mental health services.

Method We searched 29 electronic bibliographic databases and acquired randomised trials involving sex offenders, arsonists or people clearly and actively aggressive, or abusive of children or spouse. Two researchers reliably extracted data.

Results Of 409 studies found, we able to acquire 300 for further inspection. They all involved particularly violent people (total n=28 669), mostly adult men; the mean study size was 197 (median 52, mode 60, range 1-1200).In these randomised trials over 700 interventions were evaluated and short-term outcomes were recorded on 345 different scales.

Conclusions Wider collaboration, rationalising treatments and simplifying outcomes could further strengthen the tradition of trialling in forensic psychiatry. Systematic reviews of these studies are overdue.

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				C. E. Adams, E. S. F. Coutinho, J. Davis, L. Duggan, S. Leucht, C. Li, and P. Tharyan Cochrane Schizophrenia Group Schizophr Bull, March 1, 2008; 34(2): 259 - 265. [Full Text] [PDF]

				P. Tyrer, S. Cooper, E. Herbert, C. Duggan, M. Crawford, E. Joyce, D. Rutter, H. Seivewright, S. O'Sullivan, B. Rao, et al. The Quantification of Violence Scale: a Simple Method of Recording Significant Violence International Journal of Social Psychiatry, November 1, 2007; 53(6): 485 - 497. [Abstract] [PDF]