Leo Sher, M.D.

Our research paper, “Gender differences in the clinical characteristics and psychiatric comorbidity in patients with antisocial personality disorder” was published 5 years ago in the October 2015 issue of Psychiatry Research (1).

Relatively little is known how males and females differ in their manifestations of antisocial personality disorder. We have conducted a study to compare demographic and clinical features of men and women with antisocial personality disorder.

Our sample consisted of 323 participants with antisocial personality disorder, 253 men and 70 women. The study participants were treatment seeking patients. Diagnosis was established using Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Structured Interview for DSM-IV Personality Disorders (SIDP-IV).

Women had fewer episodes of antisocial behavior involving or not involving police, higher scores on the Childhood Trauma Questionnaire (CTQ) and on Emotional Abuse and Sexual Abuse subscales of the CTQ compared to men. CTQ scores positively correlated with the number of episodes of antisocial behavior involving police in men but not in women. The percentage of patients with comorbid borderline and histrionic personality disorders was higher and the percentage of participants with cocaine use disorder was lower among women compared to men. Comorbid alcohol use disorder was frequent in both groups, while a higher percentage of women had comorbid mood disorders compared to men. Logistic regression analysis demonstrates that CTQ scores, histrionic personality disorder, and antisocial behavior involving the police drive the difference between the groups.

Our findings indicate that treatment of individuals with antisocial personality disorder should focus on the following:

(a) management of comorbid substance use disorders which is important both for men and for women;

(b) prevention of antisocial acts which is more important for men; and

(c) management of mood and personality disorders which is more important for women.

Reference

1. Sher L, Siever LJ, Goodman M, McNamara M, Hazlett EA, Koenigsberg HW, New AS. Gender differences in the clinical characteristics and psychiatric comorbidity in patients with antisocial personality disorder. Psychiatry Res. 2015 Oct 30;229(3):685-9. doi: 10.1016/j.psychres.2015.08.022. Epub 2015 Aug 12