Antisocial personality disorder in patients with substance abuse disorders: a problematic diagnosis?

1990 ◽  
Vol 147 (2) ◽  
pp. 173-178 ◽  
Keyword(s):  
Substance Abuse ◽  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Substance Abuse Disorders

Correlates of codisorders in homeless and never homeless indigent schizophrenic men

1994 ◽  
Vol 24 (3) ◽  
pp. 681-688 ◽  
Author(s):  
C. L. M. Caton ◽  
P. E. Shrout ◽  
P. F. Eagle ◽  
L. A. Opler ◽  
A. Felix
Keyword(s):  
New York ◽  
Substance Abuse ◽  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Case Control Study ◽  
Age Of Onset ◽  
Severe Form ◽  
Antisocial Personality ◽  
Key Aspects ◽  
Control Study

SynopsisWe recently completed a case–control study of 100 literally homeless and 100 never homeless indigent schizophrenic men in New York City, in which concurrent substance abuse and antisocial personality disorder were widespread. In this paper we probe the correlates of ‘pure’ schizophrenia (single disorder, N = 60), schizophrenia and substance abuse (double disorder, N = 89), and schizophrenia, substance abuse, and antisocial personality disorder (triple disorder, N = 50), across the homeless/never homeless distinction. Subjects were recruited from a homeless shelter and mental health service programmes in Upper Manhattan. Psychologist and social worker interviewers administered the Structured Clinical Interview for DSM-III-R, I, and II and other structured instruments to explore social, family and illness history, the current illness, and aspects of treatment and family support. Codisorder subjects emerged from more disadvantaged family backgrounds, experienced greater school difficulties, began drug use in early adolescence, were more prone to hyperactivity in childhood, and were more likely to have spent time in jail. While codisorder groups did not differ on key aspects of schizophrenia, the triple disorder group was found to suffer from a more severe form of substance abuse than double disorder subjects, associated with an earlier age of onset and abuse of a wider array of substances.The widespread prevalence of codisorders among indigent schizophrenic men has major significance for clinical psychiatry. Study of the correlates of codisorders has revealed important differences in social, family, and illness history which may guide the development of more effective treatments and improved service delivery.

Reaching Out to Patients with Antisocial Personality Disorder with Brief Psychoeducation

2017 ◽  
Vol 41 (S1) ◽  
pp. S70-S71
Author(s):  
M. Hesse ◽  
B. Thylstrup
Keyword(s):  
Substance Abuse ◽  
Substance Use ◽  
Personality Disorder ◽  
Substance Abuse Treatment ◽  
Substance Use Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Treatment As Usual ◽  
Abuse Treatment

IntroductionPatients with antisocial personality disorder incur high costs on society, and are at high risk of dropping out of treatment and are often excluded from treatment, yet very little research has been conducted on how to best help these patients.ObjectivesTo test a six-session psychoeducation program, Impulsive Lifestyle Counselling, in outpatients with substance use disorders and antisocial personality disorder.AimsTo test the efficacy of the intervention versus treatment as usual in community outpatient treatment for substance use disorders.MethodsPragmatic randomized trial in 13 outpatient community substance abuse treatment uptake areas. Patients were interviewed by blinded interviewers 3, 9 and 15 months post-randomization and tracked through a national substance abuse treatment register. Mixed effects regression were used to assess substance use and self-reported aggression and Cox regression was used to assess risk of dropout.ResultsA total of 175 patients was randomized. At 3-month follow-up, patients randomized to intervention reported more days abstinent and less drug use severity than patients randomized to treatment as usual. In addition, patients randomized to intervention were at lower risk of dropout after intervention. In addition, patients randomized to intervention were more likely to report having received help for antisocial personality disorder at follow-up interviews.ConclusionsA brief psychoeducational intervention may improve outcomes for outpatients with antisocial personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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