Antisocial personality disorder

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Preparing for your appointment

By Mayo Clinic staff

In some cases, a health care provider or other professional may ask you about your mood, thoughts or behavior. Your doctor may bring it up during a routine medical appointment if you seem to be sad, agitated or angry, for instance. Or you may decide to schedule an appointment with your family doctor or general practitioner to talk about your concerns.

In either case, because antisocial personality disorder often requires specialized care, you may be referred to a mental health provider, such as a psychiatrist or psychologist, for evaluation and treatment. In other cases, you may seek out a mental health provider on your own first. In some cases, the court system may order you to seek evaluation and treatment.

What you can do
Being an active participant in your care can help your efforts to manage your antisocial personality disorder. One way to do this is by preparing for your appointment. This may be especially important when you have antisocial personality disorder because it tends to create antagonistic relationships with medical professionals. Think about your needs and goals for treatment. Also, write down a list of questions to ask. These may include:

  • Why do I think I have antisocial personality disorder?
  • Why can't I get over antisocial personality disorder on my own?
  • How do you treat antisocial personality disorder?
  • Will psychotherapy help?
  • Are there medications that might help?
  • How long will treatment take?
  • What can I do to help myself?
  • Are there any brochures or other printed material that I can take home with me?
  • What Web sites do you recommend visiting?

In addition to the questions that you've prepared to ask, don't hesitate to ask questions at any time during your appointment if you don't understand something.

What to expect from your doctor
During your appointment, your doctor or mental health provider is likely to ask you a number of questions about your mood, thoughts, behavior and urges. You may be asked such questions as:

  • When did you first notice symptoms?
  • How is your daily life affected by your symptoms?
  • What other treatment, if any, have you had?
  • What have you tried on your own to feel better or control your symptoms?
  • What things make you feel worse?
  • Have family or friends commented on your mood or behavior?
  • Have any relatives had a mental illness?
  • What do you hope to gain from treatment?
  • What medications or over-the-counter herbs and supplements do you take?
  • What kinds of problems, if any, have you had with the law?
  • Have you ever harmed yourself or someone else?
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, D.C.: American Psychiatric Association; 2000.
  2. MacManus D, et al. Personality disorders. Medicine. 2008;36(8):436-441.
  3. Pfohl B. Personality disorders. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2008.
  4. Kiraly B. Patient information handout. Mental illness: Taking care of yourself. American Academy of Family Physicians. 2008;78(3). https://secure.aafp.org/login. Accessed Aug. 1, 2008.
  5. Staying well when you have a mental illness. Mental Health America. http://www.nmha.org. Accessed July 2008.
  6. Goldstein RB, et al. Lack of remorse in antisocial personality disorder: Sociodemographic correlates, symptomatic presentation, and comorbidity with Axis I and Axis II disorders in the National Epidemiologic Survey on Alcohol and Related Conditions. Comprehensive Psychiatry. 2006;47(4):289-297.
  7. Devens M. Personality disorders. Primary Care. 2007;34(3):623-640.
  8. Ward R. Assessment and management of personality disorders. American Family Physician. 2004;70(8):1505-1512.
  9. Andrade JT. The inclusion of antisocial behavior in the construct of psychopathy: A review of the research. Aggression and Violent Behavior. 2008;13:328-335.
  10. De Clercq B, et al. Childhood antecedents of personality disorder. Current Opinion Psychiatry 2007;20(1):57-61.
  11. Paris J. Clinical trials of treatment for personality disorders. The Psychiatry Clinics of North America. 2008;31(3):517-526.
  12. Davidson KM, et al. Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: An exploratory randomized controlled trial. Psychological Medicine. In press. 2008.
  13. Gelhorn HL, et al. DSM-IV conduct disorder criteria as predictors of antisocial personality disorder. Comprehensive Psychiatry. 2007;48(6):529-538.
  14. Skodol AE., et al. Personality disorders. In: Hales RE. et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing Inc. 2008.

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Oct. 9, 2008

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