Dinwiddie S H, Reich T
Department of Psychiatry, Washington University School of Medicine, St Louis, MO.
Compr Psychiatry. 1993 Jul-Aug;34(4):235-42. doi: 10.1016/0010-440x(93)90004-n.
Two methods for diagnosing antisocial personality disorder (ASPD) were compared based on whether antisocial symptoms that occurred when subjects also experienced alcohol- or other drug-related problems were counted toward the diagnosis of ASPD. From a family study of alcoholism and ASPD, 93 male subjects who met ASPD criteria in the absence of substance-related problems were contrasted with 312 subjects who were diagnosed with ASPD regardless of whether criterion symptoms occurred along with substance-related problems. Subjects did not differ in types of antisocial behaviors, age of onset of behaviors, or comorbid psychiatric disorders except for alcoholism and drug abuse. A subgroup was contrasted on family history of psychiatric illness, with no differences noted between groups. Counting antisocial symptoms toward the diagnosis of ASPD regardless of whether symptoms occur during periods of substance abuse increases the observed population prevalence of the disorder, but does not change the observed phenomenology of ASPD or affect commonly accepted indicators of validity of diagnosis.
基于在受试者同时存在酒精或其他药物相关问题时出现的反社会症状是否计入反社会人格障碍（ASPD）的诊断，对两种诊断ASPD的方法进行了比较。在一项关于酗酒和ASPD的家族研究中，将93名在无物质相关问题时符合ASPD标准的男性受试者与312名无论标准症状是否与物质相关问题同时出现均被诊断为ASPD的受试者进行了对比。除酗酒和药物滥用外，两组受试者在反社会行为类型、行为发病年龄或共病精神障碍方面没有差异。对一个亚组的精神疾病家族史进行了对比，两组之间未发现差异。无论症状是否在药物滥用期间出现，将反社会症状计入ASPD的诊断会增加该障碍在观察人群中的患病率，但不会改变ASPD的观察现象学，也不会影响普遍接受的诊断效度指标。
