Bull. Amer. Acad. Psychiatry & the Law
23(4): 555-62, 1995.
Treatment, comprising pharmacotherapy and an educational program based on cognitive behavior
therapy, of four psychopathic, criminal men fulfilling the criteria for borderline personality disorder
and antisocial personality disorder is described. The diagnoses were made during a forensic
psychiatric evaluation. An estimation of the capacity of the central serotonergic system was
performed by analysing the platelet monoamine oxidase (MAO) activity. The pharmacotherapy was
combined with an educational program involving strategies for developing better impulse control.
All four men had earlier been regarded as resistant to conventional therapy. In the present cases, a
combined psychosocial and biological approach seemed to be effective in developing an increased
control of impulses, leading to improved coping strategies. Controlled studies are needed in order
to clarify whether the described treatment program proves beneficial.