The long-term outcome of antisocial personality disorder compared with depression,
schizophrenia, and surgical conditions.
D. W. Black, C. H. Baumgard and S. E. Bell,
Bull. Amer. Acad. Psychiatry & the Law
23(1): 43-52, 1995.
The objective of this study was to assess the long-term outcome of antisocial personality disorder
(APD) compared with depression, schizophrenia, and surgical conditions. Seventy-one men meeting
DSM-III criteria for APD and hospitalized at the University of Iowa Department of Psychiatry
between 1945 and 1970 were followed up between 1986 and 1990, an average of 29 years after
discharge. Comparison groups, collected during the Iowa 500 study, included depressed subjects (n
= 225), schizophrenic subjects (n = 200), and surgical control subjects (n = 160). Patients were rated
as having good, fair, or poor adjustment for marital, residential, occupational, and psychiatric status.
The Global Assessment Scale was also used to rate subjects. At follow-up, antisocial subjects were
doing significantly better than schizophrenic subjects for marital and residential, but not occupational
or psychiatric, adjustment. Both depressed subjects and surgical controls had significantly better
adjustment than antisocial subjects in all areas except residential status. Although these data apply
to antisocial men who had been psychiatrically hospitalized, we conclude that APD causes
significant long-term impairment in important domains of life.