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Dangerous and severe personality disorder: antecedents and origins

Imperial College, Department of Forensic Psychiatry, Academic Centre, West London Mental Health NHS Trust, Southall, Middlesex UB1 3EU, UK. Email: a.maden{at}ic.ac.uk

Declaration of interest None.

The origins of the Dangerous and Severe Pesonality Disorder (DSPD) Programme can be traced to developments in structured assessment and services for the cognitive–behavioural treatment of sexual and violent offenders in other countries. A comparison with these other services highlights the strengths and weaknesses of DSPD. The decision to use a medical model raises ethical and financial questions that may jeopardise the Programme's future.