Evidence map›Paper›PMID 42485273›Full record

Trial reportPloS one2026

Cost-effectiveness of a mentalisation-based treatment for antisocial personality disorder in males convicted of an offence on community probation in England and Wales: Multicentre, assessor-blind randomised controlled trial.

Barbara Barrett, Elizabeth Simes, Karen Yirmiya, James M S Wason, Alison Frater, Angus Cameron, Stephen Butler, Zoe Hoare, Mary McMurran, Paul Moran and 6 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Barbara BarrettInstitute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom.ORCID https://orcid.org/0000-0002-0270-6256
Elizabeth SimesResearch Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.ORCID https://orcid.org/0000-0003-1704-6278
Karen YirmiyaResearch Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.ORCID https://orcid.org/0000-0001-7580-3957
James M S WasonPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
Alison FraterSchool of Law, Royal Holloway, University of London, London, United Kingdom.
Angus CameronNational Probation Service London Division, London, United Kingdom.
Stephen ButlerPsychology Department, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.
Zoe HoareNWORTH Clinical Trials Unit, North Wales Medical School, Bangor University, Gwynedd, United Kingdom.
Mary McMurranInstitute of Mental Health, University of Nottingham, Nottingham, United Kingdom.ORCID https://orcid.org/0000-0001-5302-4215
Paul MoranCentre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Mike CrawfordDivision of Psychiatry, Imperial College London, London, United Kingdom.
Stephen PillingResearch Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
Elizabeth AllisonResearch Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
Jessica YakeleyPortman Clinic, Tavistock and Portman NHS Foundation Trust, London, United Kingdom.
Anthony BatemanResearch Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
Peter FonagyResearch Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study addresses a critical gap in the evidence base for cost-effective psychological interventions for antisocial personality disorder (ASPD) in forensic settings by presenting a full trial-based economic evaluation of mentalisation-based treatment plus probation as usual (MBT-ASPD + PAU), compared to PAU alone, for males with ASPD convicted of an offence in England and Wales. The economic evaluation adopted a societal perspective, incorporating costs to health care, the criminal justice system, and the wider societal impact of offending. Outcomes were assessed 24 months post-randomisation. The primary cost-utility analysis compared costs with quality-adjusted life years (QALYs) derived from the EQ-5D-5L, while a secondary cost-effectiveness analysis compared costs with aggression outcomes measured by the Overt Aggression Scale - Modified (OAS-M). Although missing data limited definitive conclusions regarding service use, available data suggest that participants in the PAU group spent more time in custody than those in the MBT-ASPD + PAU group. Utility scores and quality of life showed minimal variation over follow-up, with no significant differences between groups. Overall costs were lower in the MBT-ASPD + PAU group, though not statistically significant. Over the 24-month period, MBT-ASPD + PAU was associated with both reduced costs and lower aggression (as reflected in OAS-M scores), indicating that each unit reduction in aggression yielded a cost saving of approximately £93. For QALYs, MBT-ASPD + PAU appeared cost-effective compared to PAU across all values a decision-maker may be willing to pay for improvements in outcome. These findings provide preliminary evidence for the potential economic value of MBT-ASPD + PAU in a forensic ASPD population, particularly in relation to aggression reduction and the associated cost savings. Trial registrationThis trial is registered with ISRCTN (ISRCTN 32309003).

Indexed as

Antisocial Personality DisorderCost-Benefit AnalysisCriminalsAdultAggressionCost-Effectiveness AnalysisEnglandHumansMaleQuality-Adjusted Life YearsQuality of LifeWales

Identifiers

PMID42485273
PMCPMC13390880

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.