Antisocial personality disorder has tremendous negative effects not only on the individual who has the condition but also on their family and friends and on society in general.
While popular culture often refers to people with antisocial personality disorder as “sociopaths,” mental health professionals do not use that term in diagnosing or discussing the disorder.
Long-Term Health Risks
Complications for people with antisocial personality disorder include a higher risk for a wide range of physical and mental health problems as well as poor life outcomes.
Research has shown an increased risk for several mental health conditions in people with antisocial personality disorder. According to an article published in January 2017 in the Journal of Clinical Psychology, these conditions include:
- Bipolar disorder
- Post-traumatic stress disorder
- Attention deficit hyperactivity disorder
- Borderline personality disorder
- Schizotypal personality disorder (1)
Fortunately, most of these conditions can be treated with medication or behavioral therapy. Still, the individual must be willing to seek and receive treatment for their conditions, and people with this disorder are less likely to seek treatment than people who don’t have it.
Depression and ASPD
There is also an association between ASPD and
Smoking and ASPD
People with antisocial personality disorder are much more likely to smoke, use illegal drugs, and become dependent on alcohol than people without a personality disorder. In one study, more than one-half of people with antisocial personality disorder were smokers, compared with only 12 percent of the general population. More than one-half also had a drug use disorder, compared with less than 5 percent of the general population. ()
ASPD and Physical Health
The reason people with antisocial personality disorder have a higher risk of physical health problems is not entirely understood. At least some of those problems likely relate to taking bigger risks in their behavior and making choices with less regard for their personal safety. () Some could also be due to coexisting mental health problems. Depression, for example, is a risk factor for coronary artery disease.
According to a very large, long-term U.S. study, people with antisocial personality disorder have a higher risk of the following physical conditions:
- Five times greater risk of coronary artery disease
- Three times greater risk of liver disease
- Five times greater risk of gastrointestinal disease
- Twice the great risk of arthritis in men, and 1.4 times greater risk for arthritis in women
- Six times more likely to be hospitalized
- Nearly twice as likely to be hospitalized for at least three days
- Twice as likely to visit the emergency department at least two times in a year
- Twice as likely to have at least two injuries during the past year (4)
Life Outcomes for People With Antisocial Personality Disorder
People with antisocial personality disorder are also more likely to have problems holding down a job or maintaining healthy relationships. Studies have shown that they are less likely to have a college degree or some college experience than others in the general population.
In addition, a higher percentage of people with antisocial personality disorder rely on government disability income or government food assistance programs than people with no personality disorder. (4)
A long-term study found that people with antisocial personality disorder are less likely to seek, talk to, or feel close to relatives outside their immediate family, and less likely to have close friends compared with people with no antisocial symptoms. (3)
People with antisocial personality disorder also have a higher risk of early death than the average person. One study of 500 people found that they had a highly increased mortality rate, about 8.5 times that of people with other psychiatric conditions over a follow-up period of 7 years. () Other research has found that causes of this high risk of early death include suicide, drug use, and reckless behavior, such as getting into fights.
Harm to Family and Friends
A person with antisocial personality disorder may frequently harm and eventually alienate family members, friends, and work colleagues. Even if they do not directly harm individuals around them, the stress of living with or caring for someone with the condition can be higher than that for other mental illnesses.
In one study, caregivers of people with antisocial personality disorder experienced more grief and a greater burden of care than caregivers for people with other mental illnesses. () These caregivers reported symptoms of depression, anxiety, and post-traumatic stress disorder and experienced a decline in their well-being.
Caregivers of people with antisocial personality disorder should consider seeking support and possibly treatment for any symptoms they experience. If you or someone you know has talked about suicidal thoughts or shows symptoms of suicidal behavior, you may want to contact one of the following suicide hotlines:
- The National Suicide Lifeline; 800-273-8255
- The Crisis Text Line (text messaging); 741741
- The National Suicide Prevention Lifeline for people who are deaf or hard of hearing; 800-799-4889
- The National Suicide Prevention Lifeline en Español; 800-628-9454
- The Trevor line, for LGBTQ youth and young adults at risk of suicide; 866-488-7386
- Trans Lifeline, a transgender suicide hotline staffed only by transgender people; 877-565-8860 in the United States and 877-330-6366 in Canada
Social Consequences of Antisocial Personality Disorder
Perhaps the biggest cost of antisocial personality disorder is on society at large. The most serious common consequence of antisocial personality disorder is violent and other criminal behavior. Reliable statistics are not available to estimate what percentage of people with antisocial personality disorder commit crimes or engage in violent behavior, but they are heavily overrepresented in prison populations. One study of prisoners across the world found that nearly half of men (47 percent) and 1 of every 5 women in prison (21 percent) had antisocial personality disorder. ()
Studies on prison populations in specific countries or states have found varying numbers, but the percentages are always high. A study of prisoners in the United Kingdom, for example, found that 6 out of 10 male prisoners and 3 in 10 female prisoners have antisocial personality disorder. (5) A study of newly incarcerated prisoners in Iowa found that slightly over 35 percent of both male and female inmates have antisocial personality disorder. ()
It is difficult to calculate the monetary cost of antisocial personality disorder to society, but experts agree it is substantial. (5) The financial burden contributes to the costs of law enforcement, security, prisons, and the criminal justice system in general. Healthcare costs include those associated with the health of the individuals with antisocial personality disorder themselves, as well as the cost of treating the mental and physical health of victims of their crimes.
Editorial Sources and Fact-Checking
- Goldstein RB, Chou SP, Saha TD, et al. The Epidemiology of Antisocial Behavioral Syndromes in Adulthood: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III. Journal of Clinical Psychiatry. January 2017.
- Dunlop BW, DeFife JA, et al. The Effects of Sertraline on Psychopathic Traits. International Clinical Psychopharmacology. November, 2011.
- Goldstein RB, Dawson DA, Smith SM, et al. Antisocial Behavioral Syndromes and Three-Year Quality of Life Outcomes in United States Adults. Acta Psychiatrica Scandinavica. August 2012.
- Goldstein RB, Dawson DA, Chou SP, et al. Antisocial Behavioral Syndromes and Past-Year Physical Health Among Adults in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry. March 2008.
- Antisocial Personality Disorder: Treatment, Management and Prevention. NICE Clinical Guidelines, No. 77. National Collaborating Centre for Mental Health (UK). 2010.
- Bailey RC, Grenyer BF. Supporting a Person With Personality Disorder: A Study of Carer Burden and Well-Being. Journal of Personality Disorders. December 2014.
- Fazel S, Danesh J. Serious Mental Disorder in 23000 Prisoners: A Systematic Review of 62 Surveys. Lancet. February 2002.
- Black DW, Gunter T, Loveless P, et al. Antisocial Personality Disorder in Incarcerated Offenders: Psychiatric Comorbidity and Quality of Life. Annals of Clinical Psychiatry. May 2010.