Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

England and Wales introduced the administrative category of Dangerous Severe Personality Disorder (DSPD) and established special units in prisons and high-secure psychiatric hospitals for their treatment. To examine their characteristics, we approached 202 patients admitted to DSPD units; 174 consented to participate in research. All were male, and the median age was 38 years. Most were white and born in the UK. Most patients (75%) met full DSPD criteria as suffering from severe personality disorder that caused them to be dangerous. With respect to personality disorder, most had elevated psychopathic traits and 40% met criteria for psychopathy on the Psychopathy Checklist-Revised (Hare, 2003). With respect to dangerousness, 25% of patients had a history of homicide; 28%, sexual offenses; and 41%, other violent offenses. Median time spent in prison was more than 12 years. According to standardized measures of violence risk, those admitted to DSPD units resembled other groups of high risk offenders described in the international literature. There were some significant differences between those admitted to prison- versus hospital-based units. The findings confirmed that DSPD units contain dangerous offenders with no evidence of preemptive incarceration. © International Association of Forensic Mental Health Services.

Original publication




Journal article


International Journal of Forensic Mental Health

Publication Date





127 - 136