A 21-year-old man has been deceitful, impulsive, and repeatedly aggressive toward others since the age of 17, with no remorse. He was a well-behaved student with no disciplinary record before the age of 15. Why can a diagnosis of antisocial personality disorder NOT be made?
- A Because antisocial personality disorder cannot be diagnosed in men
- B Because DSM-5 requires evidence of conduct disorder with onset before the age of 15 years ✓
- C Because the patient must be at least 25 years old
- D Because remorselessness rules out antisocial personality disorder
Correct answer: B. Because DSM-5 requires evidence of conduct disorder with onset before the age of 15 years
Explanation
DSM-5 criteria for antisocial personality disorder require the person to be at least 18 years old AND to have a documented history of conduct disorder with onset before the age of 15 years. This patient's behavioural disturbance began at 17, so the developmental prerequisite is unmet and the diagnosis cannot be assigned regardless of how typical his current picture looks. Lack of remorse is actually consistent with the disorder, and the minimum age is 18, not 25.
Reference: DSM-5-TR, 2022 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.