Seán Whyte

A national survey of substance misuse and treatment outcome in psychiatric patients in medium security

This is the first national study of outcome in medium security, based on all 959 discharges between 1/4/97 and 31/3/98. Case notes were used to collect data about demographic and clinical characteristics, including substance misuse. Criminal and hospital records, plus a questionnaire sent to the responsible consultant, were used to measure outcome in the 12 months following discharge. Drug use was common, with more than three quarters (76%) of the patients ever having used any drug, including 51% with a clinically significant drug problem and 40% with alcohol problems. There were strong associations between substance misuse and age, ethnicity, diagnosis and length of stay. Patients with substance misuse problems were significantly more likely to be re-convicted during the follow up period but were not significantly more likely to be re-hospitalized. Those with alcohol problems had significantly more re-admissions than those without. Formal substance misuse treatment programmes were rare in the units surveyed, and our findings suggest that there is a large unmet need for services among mentally disordered offenders in medium security.

Reporting of personality disorder symptoms in a forensic inpatient sample: Effects of mode of assessment and response style

Abstract Self-report measures of personality disorder are known to over-report personality disorder traits consistently relative to measures based on a clinical interview. This study tests the hypothesis that there is a relationship between a participants tendency to give socially desirable responses and the discrepancy between their results on self-report and interview-based measures. The relative over-reporting of the self-report measure, the PDQ4, was confirmed, but no association was found between the magnitude of the over-reporting and the tendency to give socially desirable responses.

Editorial: Substance misuse in secure psychiatric hospitals

The issue of substance misuse in psychiatric units, especially secure ones, is rather like the ghost at the feast. Everybody knows that patients have access to illicit drugs and other harmful substances in hospital, but there is very little enthusiasm for tackling the problem. Worse, in many quarters there is a perception that the problem is insoluble: a self-defeating assumption that nothing will stop inpatients using drugs, or that the cost in both money and liberty would be insupportable. How can this widespread professional apathy be explained? In this issue, we present results from a study showing that the problem is greater than previously recognised (Scott, Whyte, Burrnett, Hawley and Maden (2004)). The key findings are that: