Randomised controlled trials relevant to aggressive and violent people, 1955-2000: a survey

Randomised trials remain the gold standard for evaluating health interventions. This applies to the criminal justice system as well as to health.

To identify and survey randomised trials relevant to forensic mental health services.

We searched 29 electronic bibliographic databases and acquired randomised trials involving sex offenders, arsonists or people clearly and actively aggressive, or abusive of children or spouse. Two researchers reliably extracted data.

Of 409 studies found, we able to acquire 300 for further inspection. They all involved particularly violent people (total n=28 669), mostly adult men; the mean study size was 197 (median 52, mode 60, range 1-1200).In these randomised trials over 700 interventions were evaluated and short-term outcomes were recorded on 345 different scales.

Wider collaboration, rationalising treatments and simplifying outcomes could further strengthen the tradition of trialling in forensic psychiatry. Systematic reviews of these studies are overdue.