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.