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How common is this disorder among prisoners?
More, if you want it
What does the patient show at screening?Tap a term: its definition, what you can do with it, and how often the exam asks it.
Definition: about half of male prisoners, and about 30% of UK female prisoners.
You can: Tell antisocial personality disorder in male prisoners from psychosis by the rate: about half against about 5%.
Definition: about 65% of sentenced male prisoners have at least one.
You can: Tell any personality disorder in sentenced men from antisocial personality disorder by the rate: about 65% against about half.
Definition: about 20% of female prisoners in England and Wales.
You can: Tell borderline personality disorder in female prisoners from antisocial personality disorder in female prisoners: about 20% against about 30%.
Definition: about 5% of prisoners, about 10 times the general rate.
You can: Tell psychosis in all prisoners from functional psychosis in male remand prisoners: about 5% against about 10%.
Definition: about 10% of male remand prisoners in England and Wales.
You can: Tell psychosis in all prisoners from functional psychosis in male remand prisoners: about 5% against about 10%.
Definition: several times more common in prisoners than in the general population.
You can: Name suicide risk as several times the general rate in prisoners.
Definition: over-represented in prisoners, with widely varying estimates.
You can: Name autism spectrum disorder as over-represented in prisoners, with estimates that vary widely.
Each card is one term. The grey line is what the patient says, which is what the question stem gives.
Summary
Personality disorder, especially antisocial personality disorder, is the most common diagnosis among prisoners.
Personality disorder, especially antisocial personality disorder, is the most common diagnosis among prisoners. Personality disorder is more common in prisoners than , depression or PTSD. People with antisocial personality disorder show a lasting pattern of disregard for other people and for rules.
About half of male prisoners have antisocial personality disorder. Worldwide surveys give about 47%, and UK surveys give 49% to 63%. About 65% of convicted () male prisoners have at least one personality disorder.
The disorder is far less common in the general population than in prisons. The disorder also runs in first-degree biological relatives. Alcohol misuse is linked to crime and to some forms of antisocial personality disorder, so cause and lifestyle are hard to separate. The disorder often occurs with alcohol-related, substance, mood and anxiety disorders.
Marcus Bailey is a sentenced prisoner at HMP Wandsworth. The in-reach nurse screens him for mental disorder. Marcus says, "I've been fighting and lying since school, and I don't feel bad about it."
About 65% of sentenced men have , and about half have antisocial personality disorder.
A patient with features of several personality disorders who meets full criteria for none can still receive an other specified personality disorder diagnosis. Drug dependence is much commoner in prisoners than in the community. Remand prisoners reported more dependence before custody than sentenced prisoners did. Volatile substance users who also use alcohol and opioids more often have antisocial personality disorder. Any personality disorder looks like antisocial personality disorder at first. Any personality disorder counts every type of personality disorder together.
Mnemonic
Antisocial: men half, women thirty. Borderline women twenty. Psychosis five. Cue: meet most often among the prisoners
About half of male prisoners and about 30% of UK female prisoners have antisocial personality disorder. About 20% of female prisoners in England and Wales have borderline personality disorder, and about 5% of all prisoners have psychosis.
Analogy
Picture a lecture theatre where every seat holds one male prisoner. About half the seats hold antisocial personality disorder, and about 65% hold any personality disorder. Only about 5% of seats hold psychosis, still ten times a public theatre.
Where the analogy breaks: one man can fill several rows at once, so the rows overlap.
5 more sections on Personality disorder, psychosis and suicide in prisoners
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