{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:12:35Z","timestamp":1784743955142,"version":"3.55.0"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["14\/186\/01"],"award-info":[{"award-number":["14\/186\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["14\/186\/01"],"award-info":[{"award-number":["14\/186\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>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\u2009+\u2009PAU), 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\u2013utility 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 \u2013 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\u2009+\u2009PAU 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\u2009+\u2009PAU group, though not statistically significant. Over the 24-month period, MBT-ASPD\u2009+\u2009PAU 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 \u00a393. For QALYs, MBT-ASPD\u2009+\u2009PAU 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\u2009+\u2009PAU in a forensic ASPD population, particularly in relation to aggression reduction and the associated cost savings.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial registration<\/jats:bold>\n                    This trial is registered with ISRCTN (ISRCTN 32309003).\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0352865","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:21:09Z","timestamp":1784740869000},"page":"e0352865","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-6256","authenticated-orcid":true,"given":"Barbara","family":"Barrett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1704-6278","authenticated-orcid":true,"given":"Elizabeth","family":"Simes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7580-3957","authenticated-orcid":true,"given":"Karen","family":"Yirmiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M. 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