A 16-YEAR TO 45-YEAR FOLLOW-UP OF 71 MEN WITH ANTISOCIAL PERSONALITY-DISORDER

We examined the long-term outcome of 71 men with antisocial personalit y disorder (ASPD) admitted to the University of Iowa Psychiatric Hospi tal. The subjects all met DSM-III criteria for ASPD based on admission records. Patients had been admitted between 1945 and 1970 and were ev aluated between 1986 and 1990, an average of 29 years following hospit al discharge. We traced 68 (96%), and 26 (36.6%) received a full or pa rtial interview; 17 (23.9%) had died. Based on personal interviews, in terviews with informants, and medical and legal records, we were able to rate globally 45: 12 (26.6%) had remitted, 14 (31.1%) had improved but not remitted, and 19 (42.2%) were unimproved. A Diagnostic Intervi ew Schedule (DIS) was administered to 21 subjects; tobacco dependence, alcohol dependence, generalized anxiety disorder, and major depressio n were frequent lifetime disorders. Remission was associated with lowe r symptom severity at intake and follow-up evaluation of more than 25 years and current sobriety. Based on the study results, we conclude th at for many, ASPD is chronic and is associated with ongoing psychiatri c, medical, and social problems. (C) 1995 by W.B. Saunders Company