Effects of diagnostic comorbidity and dimensional symptoms of attention-deficit-hyperactivity disorder in men with antisocial personality disorder.
OBJECTIVE
Although children with attention deficit hyperactivity disorder (ADHD) are at increased risk for later onset of antisocial personality disorder (APD) as adults, the utility of ADHD as either a comorbid diagnosis (ADHD(c)) or dimensional symptoms (ADHD(d)) in predicting behaviour and substance use problems in APD subjects has not been examined.


METHODS
A total of 105 adult male offenders with Structured Clinical Interview for Axis II Disorders (SCID-II)-based DSM-III-R APD were studied in terms of: (i) psychopathy scores on the Hare Psychopathy Checklist-Revised (PCL-R); (ii) ADHD(c) diagnostic comorbidity on clinically administered DSM-IV questionnaire; and (iii) ADHD(d) dimensional symptoms by means of Wender Utah Rating Scale (WURS) and Conners Adult ADHD Rating Scale (CAARS) during a 12 month study period (May 2005-May 2006).


RESULTS
Sixty five per cent of APD subjects met criteria for ADHD(c) diagnostic comorbidity with significantly increased rates of childhood neglect, parental divorce and suicide attempt, but not of psychopathy. APD subjects with ADHD(d) symptoms were noted to have earlier onset and increased rate of self-injurious behaviour (SIB), suicide attempt, and psychopathy. The psychopathy scores, in turn, were predictive of earlier onset of SIB and behavioural problems.


CONCLUSIONS
Both ADHD(c) diagnostic comorbidity and ADHD(d) symptoms need to be assessed in APD subjects and the dimensional measures may be better in detecting earlier onset SIB, suicide attempt and other behavioural problems.
Semiz
Umit B
UB
Department of Psychiatry, GATA Haydarpasa Training Hospital, Istanbul, Turkey. semizub@yahoo.com
Basoglu
Cengiz
C
Oner
Ozgur
O
Munir
Kerim M
KM
Ates
Alpay
A
Algul
Ayhan
A
Ebrinc
Servet
S
Cetin
Mesut
M
D000328:Adult; D017668:Age of Onset; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003415:Crime / Q000523:psychology / Q000706:statistics & numerical data; D004243:Divorce / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology; D011237:Predictive Value of Tests; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D014421:Turkey / Q000453:epidemiology