Antisocial personality disorder, psychopathy and injecting heroin use

Two hundred community-based methadone patients (CM); 200 prison inmates enrolled in prison methadone programs (PM); and 150 prison inmates with no history of heroin use (PNH) were interviewed to obtain diagnoses of antisocial personality disorder (ASPD) and Psychopathy Checklist-defined psychopathy. Large proportions of subjects in all three groups met the criteria for a diagnosis of ASPD (CM 44%, PM 65%, PNH 31%), with the two methadone groups having significantly higher proportions of ASPD diagnoses than non-heroin users. There were no differences between groups in the proportions diagnosed as psychopathic (CM 4%, PM 9%, PNH 4%). For each group, the proportions diagnosed as ASPD were significantly higher than the proportions diagnosed as psychopathic. Implications for the diagnosis of ASPD are discussed. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.