Black D W, Baumgard C H, Bell S E
Department of Psychiatry, University of Iowa College of Medicine, Iowa City, USA.
Bull Am Acad Psychiatry Law. 1995;23(1):43-52.
The objective of this study was to assess the long-term outcome of antisocial personality disorder (APD) compared with depression, schizophrenia, and surgical conditions. Seventy-one men meeting DSM-III criteria for APD and hospitalized at the University of Iowa Department of Psychiatry between 1945 and 1970 were followed up between 1986 and 1990, an average of 29 years after discharge. Comparison groups, collected during the Iowa 500 study, included depressed subjects (n = 225), schizophrenic subjects (n = 200), and surgical control subjects (n = 160). Patients were rated as having good, fair, or poor adjustment for marital, residential, occupational, and psychiatric status. The Global Assessment Scale was also used to rate subjects. At follow-up, antisocial subjects were doing significantly better than schizophrenic subjects for marital and residential, but not occupational or psychiatric, adjustment. Both depressed subjects and surgical controls had significantly better adjustment than antisocial subjects in all areas except residential status. Although these data apply to antisocial men who had been psychiatrically hospitalized, we conclude that APD causes significant long-term impairment in important domains of life.
本研究的目的是评估反社会人格障碍（APD）与抑郁症、精神分裂症及外科疾病相比的长期预后情况。1945年至1970年间在爱荷华大学精神病学系住院的71名符合DSM-III标准的APD男性患者，于1986年至1990年进行随访，平均出院后29年。在爱荷华500研究中收集的对照组包括抑郁症患者（n = 225）、精神分裂症患者（n = 200）和外科手术对照患者（n = 160）。根据婚姻、居住、职业和精神状态，将患者评定为适应良好、一般或较差。还使用了总体评估量表对受试者进行评分。随访时，反社会人格障碍患者在婚姻和居住方面的适应情况明显优于精神分裂症患者，但在职业或精神方面则不然。除居住状况外，抑郁症患者和外科手术对照患者在所有方面的适应情况均明显优于反社会人格障碍患者。尽管这些数据适用于曾因精神疾病住院的反社会人格障碍男性，但我们得出结论，APD会在生活的重要领域导致显著的长期损害。
