The treatability of psychopathic disorder: How clinicians decide

Abstract A clinician must establish that treatment will alleviate or prevent deterioration in a patient with psychopathic disorder to satisfy the legal conditions in the 1983 Mental Health Act. A researcher prospectively studied a consecutive series of psychopathically disordered patients referred to a Special Hospital over 1 calendar year (i.e. from February 1994 to January 1995) to determine how this test of treatability was applied. Of the 48 cases studied, 21 (44%) were deemed untreatable. The following factors were associated with untreatability: a referral from prison (rather than hospital); previous poor compliance with and response to treatment; an offence in which the victim was unknown to the patient; and low levels of motivation for treatment. Demographic, criminological and diagnostic factors showed no significant association with apparent treatability. This study suggests that clinicians are using a pragmatic approach to the treatability test relatively uninfluenced by demographic, criminolog...