Am J Psychiatry 1990; 147:173-178
Copyright © 1990 by American Psychiatric Association
Antisocial personality disorder in patients with substance abuse disorders: a problematic diagnosis?
LJ Gerstley, AI Alterman, AT McLellan and GE Woody
VA Medical Center, Philadelphia, PA 19104.
The authors' literature review suggests that the relationship between
antisocial personality disorder and substance abuse is complex and not yet
fully understood. The confusion regarding the relationship between the
disorders may be magnified by the emphasis in DSM-III and DSM-III-R on
behavioral criteria and their failure to require that antisocial behaviors
exist independently of substance abuse. The DSM-III and DSM- III-R
formulations of antisocial personality disorder may encompass two subgroups
of substance abusers--"true" psychopathic individuals and symptomatic
psychopaths with little psychopathy. Psychoneurotic symptoms and favorable
treatment responses might be found more often in the latter group.
