"Personality of the frontal lobe" in patients with comorbidity of bipolar affective disorder and antisocial personality disorder

Abstract

Patients with comorbidity of antisocial personality disorder and bipolar affective disorder represent a specific category due to permeation of clinically frequent and most serious mood disorder and a personality disorder of a particularly destructive type such as antisocial personality disorder. Previous studies of comorbidity of bipolar affective disorder and antisocial personality disorder showed relatively high prevalence rates of bipolar affective disorder in patients with antisocial personality disorder. In patients with bipolar affective disorder with the presence of antisocial personality disorder it is expected that there is a deterioration of the primary symptoms of the disease, particulary in manic phases, which is the reason of investigation of these phenomena, and why it is essential. Professional community has been familiar with the impact of neuroanatomic and neurophysiological factors on bipolar affective disorder as well as with antisocial personality disorder for more than two centuries. The most common neuroanatomic studies of patients with bipolar affective disorder and antisocial personality disorder are related to injuries and defects of the frontal cortex in general, whereas neurophysiological tests indicate deficits in brain hemispheres, a low level of excitation of the central and peripheral nervous system, abnormal EEG findings and reduced skin conductivity. Experts have paid special attention to similarities between the so-called "frontal lobe personality" and patients with comorbidity of these disorders. Analysing some of the basic characteristics of patients with "frontal lobishness" and comparing some research results of neuroanatomic and neurophysiological characteristics of patients with comorbid bipolar disorder and antisocial personality disorder, we try to distance ourselves from the trend that the etiological basis of these disorders is far away from the neurophysiological basis.