Antisocial personality disorder

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  • A pervasive pattern of disregard for and violation of the rights of others

Clinical Features

  • Three (or more) of the following criteria, occurring since age 15 years:[1]
    • Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
    • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
    • Impulsivity or failure to plan ahead.
    • Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
    • Reckless disregard for safety of self or others.
    • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
    • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
  • The individual is at least age 18 years
  • There is evidence of conduct disorder with onset before age 15 years
  • The occurrence of antisocial behavior is not exclusively during the course of schizo­phrenia or bipolar disorder

Differential Diagnosis


  • A clinical diagnosis; however if entertaining other organic causes may initiate workup below

General ED Psychiatric Workup


  • Set clear boundaries and expectations
  • Referral for outpatient psychiatric treatment, although difficult to treat with psychotherapy. Antipsychotics, antidepressants and mood stabilizers can be used to control symptoms such as aggression and impulsivity


  • Discharge

See Also

External Links


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.