May 2010  << Back  

Antisocial personality disorder in incarcerated offenders: Psychiatric comorbidity and quality of life

Donald W. Black, MD

Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa Department of Corrections, Iowa Medical and Classification Center, Oakdale, IA, USA

Tracy Gunter, MD

Department of Psychiatry and Neurology, St. Louis University School of Medicine, St. Louis, MO, USA

Peggy Loveless, PhDJeff Allen, PhD

Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA

Bruce Sieleni, MD

Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa Department of Corrections, Iowa Medical and Classification Center, Oakdale, IA, USA

BACKGROUND: We determined the frequency of antisocial personality disorder (ASPD) in offenders. We examined demographic characteristics, psychiatric comorbidity, and quality of life in those with and without ASPD. We also looked at the subset with attention-deficit/hyperactivity disorder (ADHD).

METHODS: A random sample of 320 newly incarcerated offenders was assessed using the Mini International Neuropsychiatric Interview (MINI), the 36-item Short Form Health Survey (SF-36), and the Level of Service Inventory–Revised (LSI-R).

RESULTS: ASPD was present in 113 subjects (35.3%). There was no gender-based prevalence difference. Offenders with ASPD were younger, had a higher suicide risk, and had higher rates of mood, anxiety, substance use, psychotic, somatoform disorders, borderline personality disorder, and ADHD. Quality of life was worse, and their LSI-R scores were higher, indicating a greater risk for recidivism. A subanalysis showed that offenders with ASPD who also had ADHD had a higher suicide risk, higher rates of comorbid disorders, and worse mental health functioning.

CONCLUSION: ASPD is relatively common among both male and female inmates and is associated with comorbid disorders, high suicide risk, and impaired quality of life. Those with comorbid ADHD were more impaired than those without ADHD. ASPD occurs frequently in prison populations and is nearly as common in women as in men. These study findings should contribute to discussions of appropriate and innovative treatment of ASPD in correctional settings.

KEYWORDS: antisocial personality disorder, offenders, prison, incarceration

ANNALS OF CLINICAL PSYCHIATRY 2010;22(2):113-120

CORRESPONDENCE: Donald W. Black, MD, Psychiatry Research/2-126B MEB, University of Iowa Carver College of Medicine, Iowa City, IA 52242 USA E-MAIL: donald-black@uiowa.edu

 
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