Treatment

There is no firm evidence that psychiatric treatment is helpful, but the Mental Health Act 1983 permits compulsory admission if it is considered likely that treatment will 'alleviate or prevent deterioration of the condition'. Many psychopaths have been admitted to hospital under the Act in the past, although there is increasing reluctance to do this unless there is clear treatability.

The most effective management is thought to be psychotherapy in a group composed of other sociopaths. The key point is to encourage the patient to take responsibility for his own conduct. Therapeutic communities for this purpose include those at the Henderson Hospital, Broadmoor Hospital, and Grendon Underwood Prison. Individual psychotherapy is seldom successful, as patients are often manipulative and unreliable in attendance.

Lithium and/or long-acting depot antipsychotics are sometimes tried to control aggression and mood swings. However, use of this medication must be very cautious. As well as elevated risk of overdose, dependence, or abuse, medication may affect the patient's understanding of his condition. If the doctor is prescribing antipsychotics, the patient may see himself as mentally ill, and think that he does not have responsibility for his conduct. He might seek to blame the doctor for inadequate treatment if he committed a criminal offence, for example. In general, the role of medication is limited.

0 0

Post a comment