Predictors of long-term outcome in 45 men with antisocial personality disorder

We sought to determine variables predictive of outcome in a group of 45 men with antisocial personality disorder followed up a mean of 29 years following hospitalization. Based on personal interviews, interviews with informants, and medical and legal records, sufficient information was available to rate the global outcome in 45 men. The Global Assessment Scale (GAS) was also used to measure functioning in 44 men at intake and follow-up. Twenty-six (57.8%) were rated as having "any improvement." Univariate analysis showed men experiencing improvement were more likely to have high GAS scores at intake, were not currently alcoholic, were older, and were followed over a longer period of time. Low GAS scores at intake and the interaction between the GAS score at intake and current alcoholism independently predicted poor outcome on regression analysis. A low GAS score at intake and shorter follow-up also independently predicted poor outcome, even though stepwise regression revealed the strongest single predictor to be the interaction between the initial GAS score and age at follow-up. In summary, long-term outcome in antisocial males is associated with an initial level of severity, alcohol consumption at follow-up, and both age at follow-up and length of follow-up. Initial severity best predicts outcome among men not currently alcoholic who have been followed over a long period of time.