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Lack of quality assurance in forensic psychiatry: false positive prevalence of antisocial personality disorder among norwegian inmates on preventive detention

Published online by Cambridge University Press:  16 April 2020

H. Vaeroy*
Affiliation:
Psychiatric R&D, Akershus University Hospital, Loerenskog, Norway

Abstract

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Introduction

A Norwegian government publication (1) claims a prevalence of around 50% of Antisocial Personality Disorder (APD) in a small group of male detainees on preventive detention. The present study population is recruited from more or less the same population as those among whom a 50% prevalence of APD has been claimed (1). Norwegian forensic investigators rarely (17%) apply psychometric tools to confirm their clinical diagnosis (2).

Aims

To confirm the diagnosis of APD applying SCID axis II. Methods: Fifty six inmates were available at the prison. Twenty eight were willing to participate (50%). Two were excluded. Thus, 26 (46%) inmates participated. DSM IV, SCID axis II was applied.

Results

None of the 26/56 matched the APD criteria, mainly failing to fulfil the diagnosis of Conduct Disorder (CD) before the age of 15 years. All the inmates had a history of antisocial behaviour.

Conclusions

To explain the claim of around 50% APD in view of the present results, close to 100% APD should be found among the remaning thirty non-participating inmates. We consider this unlikely.

A diagnosis of APD based on the history of antisocial behaviour alone represents a pitfall. Lack of quality assurance could lead to false positive diagnosis. The need for a standardized approach and quality assurance in Norwegian forensic psychiatric evaluations seems nevessary to avoid false positive diagnosis.

Type
P02-201
Copyright
Copyright © European Psychiatric Association 2011

References

Grøndahl, P., et al.Int J Law Psychiat 2009; 32: 28128710.1016/j.ijlp.2009.06.007CrossRefGoogle Scholar
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