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Review
. 2015 Jul;60(7):309-14.
doi: 10.1177/070674371506000703.

The Natural History of Antisocial Personality Disorder

Donald W Black  1
Affiliations
Review

The Natural History of Antisocial Personality Disorder

Donald W Black. Can J Psychiatry. 2015 Jul.

Abstract
in English, French

Antisocial personality disorder (ASPD) is characterized by a pattern of socially irresponsible, exploitative, and guiltless behaviour. ASPD is associated with co-occurring mental health and addictive disorders and medical comorbidity. Rates of natural and unnatural death (suicide, homicide, and accidents) are excessive. ASPD is a predictor of poor treatment response. ASPD begins early in life, usually by age 8 years. Diagnosed as conduct disorder in childhood, the diagnosis converts to ASPD at age 18 if antisocial behaviours have persisted. While chronic and lifelong for most people with ASPD, the disorder tends to improve with advancing age. Earlier onset is associated with a poorer prognosis. Other moderating factors include marriage, employment, early incarceration (or adjudication during childhood), and degree of socialization.

Le trouble de la personnalité antisociale (TPAS) est caractérisé par un modèle de comportement socialement irresponsable, exploiteur et sans remords. Le TPAS est associé à des troubles de santé mentale et de dépendance co-occurrents et à une comorbidité médicale. Les taux de décès naturels et non naturels (suicide, homicide, accidents) sont excessifs. Le TPAS est prédicteur d’une mauvaise réponse au traitement. Le TPAS débute tôt dans la vie, habituellement vers l’âge de 8 ans. Diagnostiqué comme trouble des conduites dans l’enfance, le diagnostic devient celui du TPAS à 18 ans si les comportements antisociaux ont persisté. Bien que le trouble soit chronique et durant toute la de vie pour la plupart des personnes souffrant du TPAS, il tend à s’améliorer en vieillissant. Un début plus précoce est associé à un moins bon pronostic. D’autres facteurs modérateurs sont notamment le mariage, l’emploi, l’incarcération précoce (ou une décision judiciaire dans l’enfance), et un degré de socialisation.

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