Antisocial personality disorder (ASPD) is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and persists into adulthood. Individuals with ASPD often engage in deceitful, impulsive, and aggressive behaviors, show reckless disregRead more
Antisocial personality disorder (ASPD) is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and persists into adulthood. Individuals with ASPD often engage in deceitful, impulsive, and aggressive behaviors, show reckless disregard for safety, fail to sustain consistent work or financial responsibilities, and lack remorse after harming others.
Clinical features (DSM-5 criteria—three or more since age 15):
• Failure to conform to social norms with respect to lawful behaviors (grounds for arrest)
• Deceitfulness (lying, aliases, conning others)
• Impulsivity or failure to plan ahead
• Irritability and aggressiveness (repeated physical fights)
• Reckless disregard for safety of self or others
• Consistent irresponsibility (work, financial)
• Lack of remorse (indifference or rationalization of having hurt others)
Additional requirements: at least 18 years old, evidence of conduct disorder onset before age 15, and exclusion of schizophrenia or bipolar disorder as the primary cause.
Management (short):
1. Psychosocial interventions
– Structured, cognitive-behavioral group or individual therapy to address impulsivity, anger and interpersonal skills
– Psychoeducation for patient and family on risk factors, boundaries and relapse prevention
– Social and vocational rehabilitation to improve functioning
2. Pharmacotherapy (no FDA-approved “anti-ASPD” drug; symptomatic use)
– Low-dose mood stabilizers or atypical antipsychotics for aggression/impulsivity
– SSRIs for comorbid anxiety, depression or obsessive features
3. Comorbid and risk management (per NICE guidelines)
– Concurrent treatment of substance misuse or other mental disorders.
– Coordination with criminal justice and social services for risk assessment, monitoring and support.
Definition of Schizophrenia Schizophrenia is a chronic mental health disorder marked by profound disruptions in perception of reality, thinking, emotion and behaviour. It typically presents with positive symptoms (hallucinations, delusions, disorganized speech), negative symptoms (flattened affect,Read more
Definition of Schizophrenia
Schizophrenia is a chronic mental health disorder marked by profound disruptions in perception of reality, thinking, emotion and behaviour. It typically presents with positive symptoms (hallucinations, delusions, disorganized speech), negative symptoms (flattened affect, social withdrawal, diminished motivation) and cognitive impairments (poor attention, memory, executive function), causing significant functional decline across personal, social and occupational domains.
Classification of Schizophrenia
1. Classical Subtypes (no longer distinct DSM-5 diagnoses but still useful as treatment specifiers):
– Paranoid: Predominant delusions of persecution or grandeur, auditory hallucinations.
– Disorganized (Hebephrenic): Fragmented thought and speech, inappropriate affect, disorganized behaviour.
– Catatonic: Motoric immobility or excessive purposeless activity, mutism, posturing.
– Undifferentiated: Symptoms spanning more than one subtype without a dominant clinical picture.
– Residual: History of at least one acute episode, with current predominance of negative or mild residual symptoms.
2. DSM-5 Specifiers (subtype labels removed in 2013 due to overlap and low diagnostic validity; instead clinicians add specifiers to describe current features):
See less– With catatonia
– First-episode, currently in acute episode/partial remission/full remission
– Continuous
– With a good/fair/poor prognostic features
– With prominent negative symptoms.