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27 Epidemiology of DSM-Ill PDs
school. Less than half of the diagnosed subjects had a significant record
of arrest. Occupational problems were found in 94% of the sample, violence
in 85%. and severe marital difficulties in 67%. Some form of substance
abuse occurred in 84% of individuals with antisocial PD.w
Associations with schizophrenia and mania were also found.
In the Christchurcb Psychiatric Epidemiologic Study, carried out in
New Zealand with a methodology similar to the ECA, six month and
lifetime antisocial PD prevalence rates of 0.9% and 3.1% were found
among a sample of 1498 adults, aged 18 to 64 years.2s Males showed
antisocial PD more frequently than females for both the six month (1.3%
vs 0.5%) and lifetime (4.2% vs 0.5%) prevalence, but the differences did
not achieve statistical significance. The authors also studied the one-year
recovery rate, defined as the percentage of persons who had ever met criteria
for a DIS DSM-111 disorder but who had not experienced an episode
or key symptoms of the disorder in the 12-months prior to the interview.
The recovery rate for antisocial PD was 51.6%. However, it is possible
that many recovered subjects were substance abusers, who no longer
appeared personality disordered when abstinent.
In the Edmonton (Canada) study 3258 randomly selected adult household
residents were interviewed with the DIS,Z2' and 33.8% of the pop
ulation met criteria for one or more disorders at some time in their life. A
prevalence rate of 3.7% (6.5% for males and 0.8% for females) was
found for antisocial PD. The disorder showed the highest me in the age
group 18-34, and among widowed, separated, and divorced subjects.
The mean age of onset was 8 years for males and 9 years for females. All
cases of antisocial personality had their onset before 20 years of age.
In Taiwan the rates of antisocial personality were considerably lower,
ranging from 0.03% in rural villages to 1.4% in metropolitan Tai~ei.2~
This was consistent with the lower rates of most DSM-III disorders at the
Taiwan site. In a survey of 131 subjects living in an Indian village in the
western US, who were administered the SADS-L, only one male and no
female cases were f0und.2~
Lee et al.M performed a replication of the ECA study in the city of
Seoul. Korea. They found a prevalence rate of antisocial personality disorder
of 2.08% in a community sample of 3134. As in other studies there
was a higher prevalence in males than females (3.54% vs 0.78%).
Another replication of the ECA studya1 in Hong Kong, gave a prevalence
of antisocial personality disorder of 2.78% in males and 0.53% in
females in a sample of 7229 subjects. Antisocial personality disorder
was one of the four most prevalent mental disorders found in males.