Feature Article

Antisocial personality disorder: managing the healthcare relationship

Kimberlie Dean, Daria Korobanova



Antisocial personality disorder traits often have a significant impact on a patient’s relationships with healthcare providers and can hinder the ability of primary care physicians to effectively and safely manage the individual’s physical and mental health needs.

Key Points

  • Individuals with antisocial personality disorder often present in the context of other primary physical and mental health conditions (including depression, anxiety, substance misuse and impulse control disorders); they rarely, if ever, present with the disorder as their primary complaint.
  • Antisocial personality disorder is characterised by an enduring pattern of antisociality – that is, irresponsible and exploitative behaviour, recklessness, deceitfulness and other complex behaviours that lead to negative outcomes for the individual and others. These patients also have high rates of comorbidities of physical and mental ill health.
  • To improve health outcomes, it is important to consider common challenges to diagnosis and treatment associated with the presence of antisocial personality disorder and to develop ways to manage the therapeutic relationship safely and effectively.
  • Individuals who appear to have better insight into their dysfunctional personality traits may benefit from referral to a mental health clinician for psychological interventions. Individuals with significant comorbid mental ill health or antisocial features that raise significant risks of harm to self and others may also require specialist referral.

    Picture credit: © Stephen Carroll Photography/Getty Images. Model used for illustrative purposes only.