CONDUCT DISORDER AND ANTISOCIAL PERSONALITY IN ADULT PRIMARY-CARE PATIENTS

BACKGROUND. Conduct disorder has been linked to substance use disorder s in clinical populations. This study examined the relationships of co nduct disorder and antisocial personality (ASP) disorder to substance use, substance abuse problems, depression, and demographic factors in primary care settings. METHODS. As part of a larger clinical trial, a survey of 1898 patients in the offices of 64 primary care physicians w as conducted using a self-administered health habits questionnaire. Ch ildhood conduct disorder and adult antisocial personality disorder wer e assessed using criteria from the Diagnostic and Statistical Manual o f Mental Disorders, Third Edition, Revised. RESULTS. Eight percent of men and 3.1% of women met criteria for a diagnosis of ASP disorder. Th e frequency of a history of childhood conduct disorders was higher, wi th 13.4% for men and 4% for women. Antisocial personality disorder was predicted by male sex, being unmarried (single, separated, divorced), lifetime history of depression, binge drinking, self-reported history of drug problems, current smoking, and younger age. The predictors of a history of child conduct disorder were similar to those of ASP. CON CLUSIONS. Primary care physicians treat many patients who have persona lity disorders and other conditions such as alcohol problems and depre ssion. These patients need to be identified because of the high potent ial for comorbidity and the barriers to treatment inherent in these di sorders.