Developing a national institute of clinical excellence and health guideline for antisocial personality disorder
Duggan, Conor Kane, Eddie
Duggan, Conor
Kane, Eddie
Abstract
Antisocial personality disorder (ASPD) is a common disorder with a prevalence rate in the general population of around 1%, which means that it is as prevalent as other major psychiatric conditions such as schizophrenia and bipolar disorder. People with ASPD tend to present for treatment because of a comorbid disorder, such as substance misuse, depression and anxiety or because they have been legally mandated to do so. Consequently, their commitment is often lukewarm with a high rate of noncompletion. Individuals with ASPD are often treatment rejecting and rejected by those who should be treating and supporting them. Despite this bleak picture ASPD is very costly in human and financial terms to society, the individual and their family and social networks yet targeted services and support are minimal and individuals with ASPD are among the most excluded in our society. Clearly intervention was necessary to stem the loss of human and financial capital under the current system. It was for this reason that the decision was taken that the National Institute of Clinical Excellence and Health (NICE) would produce a guideline to stimulate action based on the best available evidence. The Guideline, Anti-social personality disorder: Treatment, management and prevention, was published in 2009 (NICE, 2009). It aims to make its decisions on the best available research evidence and to do so in a transparent way. Producing the Guideline presented a number of challenges to the Guideline Development Group (GDG). The GDG decided on a pragmatic, practical, threefold strategy to resolve the dilemma. As the GDG had been asked specifically to consider prevention, we examined the literature on the treatment of childhood conduct disorder (CD), for which there was a reasonable evidence base, including some high-quality RCTs, widened the search for relevant literature by reviewing studies from related populations, and examined the evidence for the treatment of the relevant co-morbid conditions in those with ASPD. The ASPD Guideline presents a practical, positive and optimistic approach to work with people with ASPD that is becoming increasingly common in the offending literature. It aims to act as an antidote to much of the negativity that many with ASPD have habitually experienced. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Date
2010
Type
Article
Subject
Personality disorders, Antisocial personality disorder, Organisation and administration
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Citation
Duggan, C. & Kane, E. (2010). Developing a national institute of clinical excellence and health guideline for antisocial personality disorder. Personality and Mental Health, 4 (1), pp.3-8.