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.