The Relationship between Antisocial Personality Disorder and Addiction in AL-Diwanyia Governorate Case-control

: Objective : The aim of this study is to identify the relationship between antisocial personality disorder and addiction. Methodology: A descriptive Case-control study was conducted in AL-Diwanyia Teaching Hospital, Psychiatric Department from 6 May 2015 to 30 of June 2015 on a non-probability (purposive sample) of 20 addicted patients and 20 of healthy person were matched with them from general population. The data were collected through the use of semi-structured interview, the questionnaire prepared by Robert Harry and translation of AL-Saadani, Data was analysis through descriptive and inferential statistic. Results: The findings of the present study indicate there is relationship between antisocial personality disorder and addiction. Conclusion: The study conclude that the antisocial personality disorder was more frequent in cases than in the control group. Recommendations: Use psychotherapy specially social skills through treating of addiction.


INTRODUCTION:
In recent years there has been much interest in the interconnections between mental health and addiction, because the addiction and psychiatric disorders are caused by a complex interplay of heredity and environmental exposure, the psychiatric disorder may be considered as a risk factor for addiction (1) .
Numerous studies have addressed the prevalence of personality disorders, especially antisocial personality disorder, among alcohol and drug abusers.they show a high but variable rate of a broad range of personality disorder in alcohol and drug abusers, and several among them have demonstrated the adverse effect of these disorders on duration of stay in treatment (2) .
Comorbidity of specific substance disorders with antisocial personality disorder is very common rates therefore the prevelance of substance dependency is hiegher in individuals with personality disorder than in the general population (3) .
Antisocial personality disorder is a psychological condition that is associated with abnormal or destructive thinking, perception and relationships with others. In other words, a person who does not have any regard for right and wrong, or for other people. Individuals who suffer from this condition are often in trouble with the police, have issues with aggression and violence, abuse drugs and alcohol and have an inability to hold down jobs or create and maintain meaningful relationships with others (4) .
Antisocial Personality disorder and substance use disorder very commonly co-occur, Since the introduction of Diagnostic and Statistical Manual of Mental Disorder third edition, there has been a growing interest in the study of the relationship between the Axis II co-morbidity among patients with substance use disorder are found on axis I in the Diagnostic and Statistical Manual of Mental Disorder (5) .
The antisocial personality disorder are established risk factors for substance use disorders in both the general population, the evidence shows that having a psychiatric illness increases vulnerability to a co morbid substance use disorder, with the highest risk associated with antisocial personality disorder, so it becomes a more severe course of addiction, including an earlier onset, more rapid progression to dependence, and greater social, legal, and physical consequences of use Indeed, the importance of antisocial personality disorder in substance abuse is reflected by the fact that similar features of this disorder (6). The study aim to The aim of this study is to identify the relationship between antisocial personality disorder and addiction.

METHODOLOGY:
Descriptive case-control study, starting from May 6th to June 30 2015. A non-probability (purposive) sample of two groups, 20 persons who were chronic addicted of drugs and alcohol addiction according the diagnosis of the consultant psychiatrists, who was visited AL-Diwanyia Teaching Hospital, psychiatric department, which provides daily management for different psychiatric inpatients and outpatients who were attending the hopital to receive their medications and 20 person of normal subjects who matched with age, gender and residential area of cases they was selected from general population who never used psychotropic drugs, these selected for comparative. The agreement of participation was obtained from all the sample of the study the data was collected by semi-structured interview with addicted persons who were attended AL-Diwanyia Teaching Hospital, psychiatric department, to complete the Antisocial Personality questionnaire, which was prepared by Robert Harry and translation of Saadani. The questionnaire consists of two parts: A is a sociodemographic data which consists of 8-items, and part B: Antisocial Personality Questionnaire which consists of 20-items according psychopathetic personality criteria according DSM IV. The face validity of the questionnaire was determined through a panel of 7 experts in the field of psychiatry.
A pilot study was conducted to determine the reliability, which was calculated through the implementation of test and retest technique on ten persons from two groups five for every one group addicted and control group and the period between the test and retest was 15 days, the result of correlation between test and retest was (0.82). data was analysis through descriptive such as frequency and percentage and inferential statistic such as chi-square, t test, point biserial.  Table 1 found that the majority of the sample (76%) they have drug abuse while that the (24 %) of sample have alcohol abuse.  Table 2 reveals that there was no significance difference between the addicted and control group, in regard to their age at P 0.05.  Table 3 indicated that there was no significant differences between the addicted and control group regarding to their gender and residential area at P 0.05.  Table 4 reveals that the mean of addicted persons (67.75) higher than the control group (37.61) that means there was a relationship between antisocial personality disorder and addiction. To test the significance difference, the researcher calculates that the t-equation, the result of correlation is significant at (P 0.05) because the value of t-calculate was (11.51) Which was higher than tabulated t (2.21) at the level of (P 0.05) and df. (38).  Table 5 indicate that the differences was not significant at p-value 0.05 that means the Antisocial Personality Disorder was not related to family income, marital status and level of education.

DISCUSSION
The present study found that the majority of the sample have drug addiction and only smaller of sample were addicted with the alcohol that was agreed with the another study which reveals that the majority of substance use disorder is drug disorder (7) .
The majority of the sample were males. This result comes along with another study which found men had a higher prevalence than women in use of heroin injection (8) . Also the result of the study indicated that the mean age was (32.33) years, this result agree with a previous study which found the mean age of sample was (36) years (9) .
The results of the present study show that the majority of the sample living at urban residential area. This result comes along with other study which indicated that the majority of the patient's subjects were resided in the urban area more than rural area (10) this shows that the urban area largest than other and the substance abuse are available for use more than rural area and in young adults peer pressure is also a risk factor for addiction that found at cafes in urban.
Concerning with the level of education of the sample, the higher group of the addicted were primary level of education. this result is disagree with the most studies which reveals that the level of education was secondary or high, the researcher interpret this result for the dysfunction of abuser that need center of rehabilitation therefore most of countries have center of rehabilitation to return to their normal life, this center not found at a psychiatry department in Al-Dewanyia hospital.
In regard to the relationship between antisocial personality disorder and addiction, the result of present study reveals that the majority of addicted in the present study were have antisocial personality disorder (65%) more than control group according the antisocial personality scale and (35%) were don't have antisocial personality disorder that may indicate to another type of personality disorder, this result was agree with the result of another study which indicated that the associations between antisocial personality disorder and specific substance use disorders were positive and statistically significant (p ≤ .05) (11) . Another study supported the result of present study that indicated comorbidity between the personality disorder and addiction, the finding of study reveals (40%) of alcoholics met criteria of personality disorder compared with (6.4%) of control study (12) .
The study indicate that no association between antisocial personality and demographic data, this result not agree with study of who found the individuals with antisocial personality disorder have low economic status , the researcher believe that this difference because the size of the sample was small (13) .

CONCLUSION:
The study conclude that the people with antisocial personality disorder are more likely to meet the criteria of alcohol and drug dependency, and drug dependency more than alcohol dependency among the sample.

RECOMMENDATION:
1-Use psychotherapy specially social skills through treating of addiction. 2-Conducted another study about addiction and another type of personality disorder.