What are the factors that contribute to aggression in patients with co-occurring antisocial personality disorder and substance abuse?

Background: A significant number of individuals with high levels of aggression have substance use disorder problems. Objective: This study aimed to evaluate the effect of substance use disorder on aggression in young men with Antisocial personality disorder (ASPD). Methods: This cross-sectional study included 328 patients and were diagnosed with ASPD with a comorbidity of substance use disorder, along with 111 healthy young male subjects. Results: The total aggression scores of the patients with a diagnosis of ASPD were significantly higher than those of the healthy group (p < 0.001). Mean scores of aggression subscale, except for indirect aggression, were higher in patients diagnosed with ASPD (p < 0.05). There was a positive correlation between aggression scores and total API scores in patients diagnosed with ASPD (p < 0.001). Aggression scores were higher when subjects were using volatile substances compared to other substances (p < 0.05). Aggression scores increased with duration of substance use disorder (p < 0.001). Discussion: Substance use disorder should be treated first to mitigate aggression in individuals with ASPD. Patients with severe addiction to volatile substances should be given treatment priority. Further studies are necessary to determine the cause of aggression in individuals who abuse substances.