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CommentAntisocial personality disorder is the most prevalent disorder in prisons. Other severe personality disorders are also frequent (borderline, narcissistic, and paranoid).In spite of their specific features all severe personality disorders are similar in certain aspects. They all have problems with control of impulses and affects, and a low stress and frustration tolerance. They are all narcissistic (self-centered), passive, demanding, and denying their own responsibilities. J. P. Sartre’s famous sentence "Hell is other people" could be used as the best description of projection, one of the main defence mechanisms of personality disorders: other people are guilty, not themselves. Personality disorders are always manifesting in interpersonal context: they need people to project their unacceptable impulses onto. They cannot stand incarceration and control by prison authorities, which often give rise to their disruptive behaviour.Disruptive behaviour of individuals with personality disorders threatens the safety and comfort of others. These disorders are frequently co-morbid with substance abuse. Both, individuals with personality disorders and with substance abuse are prone to developing depression, anxiety and even psychotic reactions. This is even more frequent in prison, under conditions of incarceration. So, you as a medical doctor will most probably have to deal with the mental health of these individuals quite often.Here we shall remind you of some of the characteristics of the antisocial personality disorder, as one of the most frequent personality disorders in prison. Prevalence of that personality disorder in special settings (substance abuse programmes, probation centres, prisons) may rise to 75 per cent [2]. It is also called dissocial [11], psychopathic, amoral, asocial, or sociopathic.[2] Singleton, N., Meltzer, H., Gatward, R., Coid, J., Deasy, D. (1998). Psychiatric morbidity among prisoners in England and Wales. Office for National Statistics, Government Statistical Service, London.[11] ICD-10 Classification of Mental and Behavioural Disorders. WHO, Geneva, 1992.
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