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Patients with personality disorder admitted to secure forensic psychiatry services

Published online by Cambridge University Press:  03 January 2018

Jeremy Coid ,
Nadji Kahtan ,
Simon Gault  and
Brian Jarman
Jeremy Coid*
Affiliation:
Academic Section of Forensic Psychiatry, St Bartholomew's and the Royal London School of Medicine and Dentistry, London
Nadji Kahtan
Affiliation:
Academic Section of Forensic Psychiatry, St Bartholomew's and the Royal London School of Medicine and Dentistry, London
Simon Gault
Affiliation:
Department of Primary Health Care and General Practice, Imperial College School of Medicine, London
Brian Jarman
Affiliation:
Department of Primary Health Care and General Practice, Imperial College School of Medicine, London
*
Professor Jeremy Coid, Forensic Psychiatry Research Unit, John Howard Centre, 2 Crozier Terrace, London E9 6AT
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Abstract

Background

Treatment of patients with personality disorder remains controversial and severe mental illness is prioritised in secure forensic psychiatry services.

Aims

To compare patients with personality disorder and mental illness according to demography, referral, criminality, previous institutionalisation and diagnostic comorbidity.

Method

A record survey of 511 patients with personality disorder and 2575 with mental illness admitted to secure forensic psychiatry services between 1 January 1988 and 31 December 1994 from half of England and Wales.

Results

Personality disorder admissions declined over time; more were female, White, younger and extensively criminal (specifically, sexual and arson offences). Personality disorder was highly comorbid; antisocial, borderline, paranoid and dependent personality disorder were most prevalent.

Conclusions

Patients with personality disorder were highly selected and previously known to psychiatric services. Referrer, diagnostic comorbidity and behavioural presentation determined their pathways into care. Future research must determine whether their continuing admission represents effective use of scarce resources and whether new services are required.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 6 , December 1999 , pp. 528 - 536
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Funding was provided by the Department of Health.

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