Repeated USMLE Questions- Question of the Day 1

A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidences of shoplifting.

Which is the most likely diagnosis?

A- Antisocial personality disorder

B- Borderline personality disorder

C- Conduct disorder

D- Histrionic personality disorder

E- Obsessive compulsive disorder

Answer 

This patient represents a typical case of antisocial personality disorder. The same scenario can also be a typical match for conduct disorder but if the patient is younger than 18 years of age.

Antisocial personality disorder is characterized by treating other people with pervasive disregard of their rights and respect. Patients with antisocial personality disorder commit crimes for personal gain and for their own pleasure. They have no remorse as they justify their behavior by blaming their victims for being foolish and deserve it. They also look indifferent to the harmful effects they cause to other people. It is more common in men than women and decreases by aging suggesting that bad experience could lead to a change of their way of life. Diagnosis is usually made by history and clinical criteria. Treatment includes cognitive-behavioral therapy, antipsychotics and antidepressants. Other choices have different criteria that do not match this scenario.

The correct answer is A

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