HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Nathan, R. Search for Related Content PubMed Articles by Nathan, R.

Women patients in medium secure psychiatric units

Scott Clinical Medium Secure Unit, Rainhill Road, St Helens, Merseyside WA9 5BD

Sir: The development of separate secure services for women (Hassell & Bartlett, Psychiatric Bulletin, September 2001, 25, 340-342) is essential. However, in my experience the campaign to develop such services is brushing aside the limitations of both our phenomenological understanding of a particular group of patients, and the evidence base for interventions for this group. These patients, who I anticipate will be instantly recognisable to clinicians, present with many features of borderline personality disorder and some "are subject to episodic descent into psychosis". I do not want to revisit the failings of the personality disorder/mental illness dichotomy. However, even when our current pharmacopoeia is exhausted, many of these patients continue to manifest evidence of severe psychological vulnerabilities, which have been present from an early age, and for which longterm psychological interventions are recommended. Forensic psychiatrists have become increasingly cautious about admitting male patients who present with problems primarily attributable to their personality. Disproportionately more women than men with a primary diagnosis of personality disorder are admitted to secure services (Coid et al, 2000). Does this gender bias reflect a particular therapeutic optimism or medical paternalism?

References

COID, J., KAHTAN, N., GAULT, S., et al (2000) Women admitted to secure forensic services: I: Comparison of women and men. The Journal of Forensic Psychiatry, 11, 275-295.[CrossRef]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Nathan, R. Search for Related Content PubMed Articles by Nathan, R.