Summary of findings 2. Impulsive lifestyle counselling + treatment‐as‐usual versus treatment‐as‐usual alone for antisocial personality disorder.
| Impulsive lifestyle counselling + treatment‐as‐usual versus treatment‐as‐usual alone for antisocial personality disorder | ||||||
| Patient or population: adults with antisocial personality disorder Setting: outpatient Intervention: Impulsive lifestyle counselling + treatment‐as‐usual Comparison: treatment‐as‐usual alone | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with treatment‐as‐usual alone | Risk with impulsive lifestyle counselling + treatment‐as‐usual | |||||
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Aggression: trait Assessed by: Buss‐Perry Aggression Questionnaire ‐ Short Form (12 items rated on 5‐point Likert scale ranging from extremely uncharacteristic (1) to extremely characteristic (5); range = 12‐60; high score = poor outcome) Timing of assessment: 9 months |
The mean trait aggression score in the control group was 3.52 points | The mean trait aggression score in the intervention group was 0.07 points higher (0.35 lower to 0.49 higher) | ‐ | 118 (1 RCT) | ⊕⊝⊝⊝ Very lowa | ‐ |
| Reconviction | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
| Global state/functioning | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
| Social functioning | ‐ | ‐ | ‐ | ‐ | ‐ | No data available |
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Adverse events: death Assessed by: number of participant deaths between a 3‐ and 9‐month follow‐up period Timing of assessment: between 3 and 9 months |
Study population | OR 0.40 (0.04 to 4.54) | 142 (1 RCT) | ⊕⊝⊝⊝ Very lowa | ‐ | |
| 31 per 1000 | 13 per 1000 (19 fewer per 1000; from 30 fewer to 96 more) | |||||
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Adverse events:incarceration Assessed by: incarceration between a 3‐ and 9‐month follow‐up period Timing of assessment: 9 months |
Study population | OR 0.70 (0.27 to 1.86) | 142 (1 RCT) | ⊕⊝⊝⊝ Very lowa | ‐ | |
| 156 per 1000 | 115 per 1000 (41 fewer per 1000; from 109 fewer to 100 more) | |||||
| *The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; RCT: Randomised controlled trial. | ||||||
| GRADE Working Group grades of evidence (Schünemann 2013) High certainty: we are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect | ||||||
aEvidence downgraded three levels overall. We downgraded two levels for limitations in the design/implementation suggested high risk of bias (‘incomplete outcome data/attrition’ bias; possible risk of ‘allocation concealment’ bias, ‘blinding of participants’ bias, ‘blinding of personnel’ bias, ‘blinding of outcome assessors’ bias, ‘selective reporting’ bias and ‘other’ bias), and one level for imprecision due to optimal information size criterion not being met .