The relationship between aggression and serum thyroid hormone level in individuals diagnosed with antisocial personality disorder.
Aggression is one of the diagnostic criteria of antisocial personality disorder (APD) ('). It is also among the symptoms of hyperthyroidism (2,3). There are few studies that indicate a correlation between serum thyroid hormone levels and aggression and tendency to commit a crime. The incidence of crime in individuals with high serum T3 levels is 3.8 times greater than that in those with normal serum T3 levels (4,5). The free T3 level of individuals with high aggression scores is more closer to the upper limit (6,7,8,9). After the application of high doses of anabolic androgenic steroids (AAS), an increase in serum free T4 and TSH levels and aggression was determined ('0). Testosterone, cortisol, and T4 levels were found to be significantly high in individuals exhibiting antisocial behavior (11).
Because of methodological problems, the results of some previous studies are controversial. There are no large-scaled and methodological studies examining the relationship between aggression and serum thyroid hormone levels in samples with antisocial personality disorder In APD, two subgroups were identified as aggression at the forefront and aggression not at the forefront. Perpetrators of violent crimes (murder mutilation, rape, arson, pugnacity, etc.) have been called "aggressive type (criminal)" Perpetrators of nonviolent crimes (theft, fraud, deceit, etc.) have been called "passive type (noncriminal)" ('2).
The aim of this study was to investigate the relationship between aggression and serum thyroid hormone levels in patients with APD. Additionally two sub-groups, "criminal" and "non-criminal" were defined according to crime history in the APD sample to compare this relationship between subgroups.
The sample group included APD patients who were admitted to the psychiatry polyclinic of a university hospital and who received inpatient or outpatient treatment in sequential order The inclusion criteria were as follows: being diagnosed with APD according to the DSM-IV-TR criteria, being between the ages of 20 and 30 years, having the necessary level of education to take the tests and participate in a structured interview (at least primary school graduates), and giving consent for the study The exclusion criteria were as follows: not giving consent for the study and having comorbid mental-physical illnesses. The control group consisted of healthy volunteers who met the inclusion criteria. Only men were included in the study to ensure the homogeneity of the group and avoid the hormonal effect of the menstrual cycle.
While defining the subgroups of APD, a classification was made based on the nature of the crime pattern. To distinguish between "criminal" and "noncriminal," the rough criteria were committing life-threatening crimes and felonies (armed attacks, grievous bodily harm, murder, arson, serious sexual assaults).
Gulhane Military Medical Academy Ethics Committee approval was received, and the study is in accordance with the Helsinki Declaration. The participants were given information about the study and their written consents were obtained. The study included a total of 100 APD patients and 100 healthy controls. Four APD patients and three healthy controls were excluded because it was found that they did not mark the test in accordance with the instructions. Impaired liver and renal function, autoimmune thyroid disease, and hormone levels outside the normal range were the exclusion criteria; however no participants were excluded because of these reasons. The study was completed with 96 APD patients and 97 healthy controls.
Case Report Form: Questions were asked regarding sociodemographic information, alcohol/substance abuse, suicidal attempts, tattoos, self-mutilation, and criminal history Subjects who committed life-threatening crimes were defined by the "criminal" (n=49) subgroup; those who did not have a history of crime or who committed other crimes were defined by the "noncriminal" (n=47) subgroup.
Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID-1): This is a structured clinical interview form developed to accommodate the DSM-IV Axis 1 diagnosis. The Turkish translation of SCID-1 was used. The reliability and validity study of the Turkish translation was performed by Corapcioglu et al. (13)
Structured Clinical Interview for DSM-III-R Axis 2 Disorders (SCID-2): This is a structured clinical interview form developed to accommodate the DSM-III-R Axis 2 diagnosis. The reliability and validity study of the Turkish translation has been performed by Sorias et al. (14)
Buss-Perry Aggression Questionnaire (BPAQ): This consists of 34 items. The conditions described in the items question five sub-forms of aggression (physical aggression, verbal aggression, anger, hostility, and indirect aggression). It is a five-point Likert-type self-assessment scale. The validity and reliability study of this scale in our country has been performed by Can (15).
Individual interviews were conducted with the patients. During this interview, SCID 1-2 and the Buss-Perry Aggression Questionnaire were applied. After overnight fasting, blood samples were taken between 7:00 and 9:00 a.m. TSH, free T3, free T4, AntiTPO, and AntiTG levels were tested. Additionally tests for evaluating the steps known to have an effect on production, emissions, and the destruction processes of hormones were also performed to exclude confounding factors that may affect thyroid hormone metabolism (GH, ACTH, free testosterone, total testosterone, DHEA-S, cortisol, albumin, AST ALT GGT creatinine).
Frequency distributions were calculated for descriptive statistics, and mean and standard deviation were calculated for continuous variables. The results were presented as mean [+ or -] standard deviation. Relationships between qualitative data were evaluated by chi-square test. While investigating the differences between the two groups, the t-test was used for data that conformed to a normal distribution, and the Mann-Whitney U test was used for data that did not conform to a normal distribution. a=0.05 was chosen as the error level, and p values less than or equal to this value were interpreted as "statistically significant differences."
Forty-nine of the APD patients (51%) were defined as "criminal" and 47 (49%) as "noncriminal." When the sociodemographic characteristics of the APD and control groups were assessed, significant differences were found in terms of age, education, substance-alcohol abuse, self-mutilation, tattoos, and suicide attempts. The number of single men among the controls was significantly higher than that in the APD group. Substance-alcohol abuse, self-mutilation, tattoos, and suicide attempts were not found in the control group (Table 1). When the sociodemographic characteristics of criminal and noncriminal APD patients were assessed, significant differences were not found in terms of age, education, and suicide attempts. Although no significant difference was detected, it was notable that the likelihood of being a criminal decreased with increasing education levels. The number of single men in the noncriminal APD group was significantly higher than that in the criminal APD group. In the criminal APD group, substance-alcohol usage, self-mutilation, and tattoos were more common than in the noncriminal APD group (Table 2).
When the aggression scores of APD and control groups were examined according to the BPAQ, total and subscale scores were significantly higher in the case group (Table 3). BPAQ, total, and subscale scores were found to be significantly higher in the criminal group than in the noncriminal group (Table 4).
While the free T4 and cortisol levels of the case group were significantly higher than those of the control group, the free T3 level of the case group was lower than that of the control group. There were no differences between the case group and the control group in terms of TSH, free testosterone, and total testosterone levels (Table 5). Serum free T3 levels were significantly higher in the criminal APD group than in the noncriminal APD group. There were no differences between the case group and the control group in terms of free T4, TSH, cortisol, free testosterone, and total testosterone levels (Table 6).
When the relationships between aggression and hormone levels were analyzed by two-tailed Pearson correlation test in the APD group, it was found that BPAQ total (r=0.363, p<0.00l) and subscale scores [(physical aggression: r=0.347, p=0.00l), (verbal aggression: r=0.227, p=0.026), (anger: r=0.398, p<0.00l), (hostility: r=0.403, p<0.00l), (indirect aggression: r=0.324, p=0.00l)] increased with increasing serum free T3 level.
When the same analysis was performed with the control group, it was found that as TSH levels increased, BPAQ total (r=-0.204, p=0.045) and verbal subscale scores (r=-0.358, p<0.00l) decreased. Another finding was that BPAQ total (r=-0.21 8, p=0.032), physical aggression subscale (r=-0.221, p=0.030), and verbal aggression subscale scores (r=-0.332, p=0.00l) decreased as free testosterone levels increased.
In the noncriminal APD group, although serum free T3 levels increased, BPAQ total (r=0.507, p<0.00l) scores decreased. Similarly it was found that five subscale scores also increased [(physical aggression: r=0.505 p<0.001), (verbal aggression: r=0.293, p=0.045), (anger: r=0.571, p<0.00l), (hostility: r=0.524, p<0.001), (indirect aggression: r=0.509, p=0.001)]. In the same group, it was found that participants with high serum free T4 levels had higher BPAQ total scores (r=0.371, p=0.010). It was found that BPAQ subscale scores increased with increasing free T4 levels [(physical aggression: r=0.355, p=0.014), (verbal aggression: r=0.389, p=0.007), (anger: r=0.349, p=0.016), (hostility: r=0.426, p=0.003)]. There was no significant relationship between BPAQ indirect aggression score and free T4 level.
It was notable that there was no significant correlation between hormone levels and BPAQ total aggression scores in the noncriminal group. However there was an opposite correlation, but it was not statistically significant.
Significantly more frequent substance-alcohol abuse, self-mutilation, tattoos, and suicide attempts as well as significantly more married cases and significantly lower levels of education were found in the APD group; these are expected findings that are consistent with the general characteristics of APD (16). The high mean age in the APD group was thought to stem from imprisonment.
The lack of a significant difference between the criminal and noncriminal groups in terms of age, education, and suicide attempts has been interpreted as an indication of intragroup homogeneity The free T4 and cortisol levels of the case group were found to be significantly higher than those of the control group, whereas the free T3 level was lower This finding was compatible with some study results but not with some others.
The reasons for these discrepancies may include the following: Some of the studies have very small sample sizes (5,6,7,8,9). A diagnostic distinction has not been made in some of the studies (4,9). The reliability of the data obtained from studies not using a healthy control group is controversial (9). The results obtained from studies with samples of psychotic prisoners (5), non-psychotic prisoners (6,7,8), and veterans (11) do not reflect the conditions in the APD sample. Different scales were used in some of the studies. Different findings may have arisen in studies conducted in different societies because of differences in culture-specific characteristics and judgments of society. Our study is important because it is the first study that examines thyroid functions in APD samples.
The mean free and total testosterone levels of the APD group were found to be higher than those of the control group. The testosterone-aggression relationship has been investigated and demonstrated by numerous studies (17). Aggressiveness increases with the use of testosterone analogs. It is not clearly known whether anabolic androgenic steroids increase aggressiveness directly by testosteronergic effects or by raising thyroid hormone levels (10). Significant differences in terms of free and total testosterone were not found between the criminal and noncriminal groups. In the criminal group, it was remarkable that the mean values of the hormones mentioned above were lower No data are available to compare this finding. In APD patients and other people with cluster B personality traits, novelty seeking, impulsivity, and aggression are high. High levels of novelty seeking have been associated with mesolimbic and mesocortical dopaminergic hyperactivity (16). Our finding suggests that aggression does not only occur due to testosterone but also other mechanisms such as dopaminergic mechanisms play a role in the formation of aggression.
When the correlation between hormone levels and aggression scores was examined in the case group, it was found that the aggression scale scores increased with increasing free T3 levels. Many previous studies focused on the differences between the mean values. A correlation analysis that --questions the causal relationship between the two variables was not per formed in these studies (6,7,8,9). The positive correlation found in our study suggests that free T3 levels play an important role in the formation of aggression. Even if free T3 levels do not indicate hyperthyroidism and remains within the normal range, it seems to be effective in causing aggression. Lithium is effective in the treatment of aggression (18). The effect of lithium may be to either directly or indirectly slow thyroid function. This finding needs to be replicated by other studies investigating the drugs used in the treatment of hyperthyroidism, such as propylthiouracil and methimazole, on aggressive people.
In the control group, a negative relationship between testosterone and aggression was found; however, it is noteworthy that this relationship was not generally found in antisocial patients and their subgroups. This finding is consistent with some research results (19,20) and not with others (7,10,21). Our finding suggests that neurobiological processes other than testosterone play a role in the formation of aggression. In both healthy individuals and individuals with APD, the effect of testosterone on aggression may develop through different pathways.
In the noncriminal APD subgroup, aggression scores were found to increase with increasing serum free T3 and free T4 levels. Although aggression increases with increasing serum thyroid hormone levels, a lack of violent behavior may be associated with high reward dependence. High reward dependence is associated with serotonergic pathways in the median raphe nucleus and noradrenergic pathways in the ceruleus (16). In addition to thyroid hormones, serotonergic and noradrenergic transmission is effective in the formation and type of aggression. In the criminal APD subgroup, a significant correlation was not detected between hormone levels and BPAQ aggression scores. Although it is not statistically significant, a negative correlation is a significant finding. It is noteworthy that although the criminal subgroup has higher mean T3 levels than the noncriminal subgroup, there was no significant correlation with aggression scores. This finding is important because it indicates that factors other than thyroid hormones may play a role in the aggression of criminals, and there may be many determinants of aggression and violent behavior (22).
In conclusion, these data gave the impression that the criminal and non-criminal groups represent two different groups sociodemographically and biologically. In the literature, although there are studies comparing APD cases with healthy individuals, these studies do not include detailed comparisons in terms of sociodemographic, clinical, and hormonal characteristics of the cases by defining subgroups. This condition prevents further comments; however in the present study it shall be considered that the data may have been interpreted differently. Detailed studies on this topic are needed. The findings suggest a relationship between thyroid hormone levels and aggression in the APD sample. Because of the lack of objective criteria defined by the International Classification System in the discrimination of criminal and non-criminal subgroups of APD, the study sample may not be sufficiently large to reflect the subgroups properly. In terms of the distinction criteria used in this study, a participant who was not a criminal during the study might become a criminal if he committed a felony later Therefore, generalization cannot be made with these findings. Studies with larger samples, questioning personality traits with psychometric tests, and using more objective criteria to distinguish the criminality of APD cases are needed. These studies will not only shed light on this subject but will also contribute to the control of aggression.
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The authors declared that this study has received no financial support.
(1.) Amerikan Psikiyatri Birligi. DSM-5 Tani Olcutleri Basvuru Elkitabi. 1. Baski. Koroglu E, cev. editoru. Ankara: Hekimler Yayin Birligi; 2014.
(2.) Brandt F, Thvilum M, Almind D, Christensen K, Green A, Hegedus L, Brix TH. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study. Eur J Endocrinol 2013; 170:341-348 [CrossRef]
(3.) Greenhill C. Thyroid function: Hyperthyroidism-psychiatric issues. Nat Rev Endocrinol 2014; 10:65. [CrossRef]
(4.) Eklund J, Alm PO, Klinteberg B. Monoamine oxidase activity and tri-iodothyronine level in violent offenders with early behavioural problems. Neuropsychobiology 2005; 52:122-129. [CrossRef]
(5.) Alm PO, Klinteberg B, Humble K, Leppert J, Sorensen S, Tegelman R, Thorell LH, Lidberg L. Criminality and psychopathy as related to thyroid activity in former juvenile delinquents. Acta Psychiatrica Scandinavica 1996; 94:112-117. [CrossRef]
(6.) Stalenheim EG. Long-term validity of biological markers of psychopathy and criminal recidivism: follow-up 6-8 years after forensic psychiatric investigation. Psychiatry Research 2004; 121:281-291. [CrossRef]
(7.) Stalenheim EG, Eriksson E, Knorring LV, Wide L. Testosterone as a biological marker in psychopathy and alcoholism. Psychiatry Research 1998; 77:79-88. [CrossRef]
(8.) Stalenheim EG, Knorring LV, Wide L. Serum levels of thyroid hormones as biological markers in a Swedish forensic psychiatric population. Biological Psychiatry 1998; 43:755-761. [CrossRef]
(9.) Soderstrom H, Formsan A. Elevated triiodothyronine in psychopathy--possible physiological mechanisms. J Neural Transm 2004; 111:739-744. [CrossRef]
(10.) Daly RC, Su PT, Schmidt PJ, Pagliaro M, Pickar D, Rubinow DR. Neuroendocrine and behavioral effects of high-dose anabolic steroid administration in male normal volunteers. Psychoneuroendocrinology 2003; 28:317-331. [CrossRef]
(11.) Mazur A. Biosocial models of deviant behavior among male army veterans. Biol Psychol 1995; 41:271-293. [CrossRef]
(12.) Henderson D, Batchelor IR. Henderson and Gillespie's Textbook of Psychiatry. 9. Baski. London: Oxford University Press; 1962.
(13.) Corapcioglu A, Aydemir O, Yildiz M, Esen A, Koroglu E. SCID'in Turkiye Icin Uyarlama ve Guvenirlilik Calismasi. Ankara: Hekimler Yayin Birligi; 1999.
(14.) Sorias S, Saygili R, Elbi H. DSM-III-R Yapilandirilmis Klinik Gorusmesi Turkce Versiyonu (SCID) Kullanim Klavuzu. Izmir: Ege Universitesi Yayinevi; 1990.
(15.) Can S. Turk Populasyonunda Saldirganlik Olceginin Turkce Uyarlamasinin Gecerlik ve Guvenirlik Calismasi, Ruh Sagligi ve Hastaliklari AD. Tipta Uzmanlik Tezi. Istanbul: GATA; 2002.
(16.) Cloninger R, Svrakic DM. Personality Disorders. BJ Sadock, VA Sadock, editorler, Comprehensive Textbook of Psychiatry icinde. 7. Baski. Philadelphia: Lippincott Williams and Wilkins; 2000; s.1723-1745.
(17.) Duke SA, Balzer BW, Steinbeck KS. Testosterone and its effects on human male adolescent mood and behavior: a systematic review. J Adolesc Health 2014; 55:315-322. [CrossRef]
(18.) Comai S, Tau M, Pavlovic Z, Gobbi G. The psychopharmacology of aggressive behavior: a translational approach: part 2: clinical studies using atypical antipsychotics, anticonvulsants, and lithium. J Clin Psychopharmacol 2012; 32:237-260. [CrossRef]
(19.) Dougherty DM, Bjork JM, Moeller FG, Swann AC. The influence of menstrual-cycle phase on the relationship between testosterone and aggression. Physiol Behav 1997; 62:431-435. [CrossRef]
(20.) Zuckerman M. Sensation seeking: a comparative approach to a human trait. Behav Brain Sci 1984; 7:413-471. [CrossRef]
(21.) Kouri EM, Lukas SE, Pope HG, Oliva PS. Increased aggressive responding in male volunteers following the administration of gradually increasing doses of testosterone cypionate. Drug Alcohol Depend 1995; 40:73-79. [CrossRef]
(22.) Susman EJ. Psychobiology of persistent antisocial behavior: Stress, early vulnerabilities and the attenuation hypothesis. Neurosci Biobehav Rev 2006; 30:376-389. [CrossRef]
Alper EVRENSEL , Baris Onen UNSALVER , Aytekin OZSAHIN 
 Department of Electroneurophysiology, Uskudar University Faculty of Health Sciences, Istanbul, Turkey
 Department of Psychiatry, Gulhane Military Medical Academy, Ankara, Turkey
Correspondence Address: Alper Evrensel, Uskudar Universitesi Saglik Bilimleri Fakultesi, Elektronorofizyoloji Bolumu, Istanbul, Turkiye
Received: 31.07.2014 Accepted: 28.12.2014
Table 1. Sociodemographic characteristics of APD patients and control group APD n=96 Control group n=97 Sociodemographic n % n % characteristics Marital status Married 36 85.7 6 14.3 Single 60 39.7 91 60.3 Education level University 2 8.3 22 91.7 High School 24 38.1 39 61.9 Secondary 16 48.5 17 51.5 Primary 39 69.6 17 30.4 Early school leaving 15 88.2 2 11.8 Alcohol abuse Yes 51 100 0 0 No 45 31.7 97 68.3 Substance abuse Yes 71 1 00 0 0 No 25 20.5 97 79.5 Self harm Yes 58 100 0 0 No 38 28.1 97 71.9 Tattoo Yes 36 100 0 0 No 60 38.2 97 61.8 Suicide attempt Yes 56 100 0 0 No 40 29.2 97 70.8 Age 23 years and under 48 39.0 75 61.0 Over 23 years 48 68.6 22 31.4 Total n=193 Statistical analysis Sociodemographic n % [chi square] p characteristics Marital status Married 42 21.8 27.788 <0.001 * Single 151 78.2 Education level University 24 12.4 37.519 <0.001 * High School 63 32.6 Secondary 33 17.1 Primary 56 29.0 Early school leaving 17 8.8 Alcohol abuse Yes 51 26.4 70.039 <0.001 * No 142 73.6 Substance abuse Yes 71 36.8 1 13.490 <0.001 * No 122 63.2 Self harm Yes 58 30.1 83.782 <0.001 * No 135 69.9 Tattoo Yes 36 18.7 44.716 <0.001 * No 157 81.3 Suicide attempt Yes 56 29.0 79.712 <0.001 * No 137 71.0 Age 23 years and under 123 63.7 15.579 <0.001 * Over 23 years 70 36.3 * p<0.05. APD: antisocial personality disorder Table 2. Sociodemographic characteristics of criminal and noncriminal APD patients Criminal Noncriminal n=49 n=47 Sociodemographic n % n % characteristics Marital status Married 25 69.4 11 30.6 Single 24 40.0 36 60.0 Education level University 0 0 2 100 High School 10 41.7 14 58.3 Secondary 9 56.3 7 43.8 Primary 20 51.3 19 48.7 Early school leaving 10 66.7 5 33.3 Alcohol abuse Yes 32 62.7 19 37.3 No 17 37.8 28 62.2 Substance abuse Yes 46 64.8 25 35.2 No 3 12.0 22 88.0 Self harm Yes 43 74.1 15 25.9 No 6 15.8 32 84.2 Tattoo Yes 28 77.8 8 22.2 No 21 35.0 39 65.0 Suicide attempt Yes 33 58.9 23 41.1 No 16 40.0 24 60.0 Age 23 years and under 22 45.8 26 54.2 Over 23 years 27 56.3 21 43.8 Total n=96 Statistical analysis Sociodemographic n % [chi square] p characteristics Marital status Married 36 37.5 7.806 0.005 * Single 60 62.5 Education level University 2 2.1 2.872 0.090 High School 24 25.0 Secondary 16 16.7 Primary 39 40.6 Early school leaving 15 15.6 Alcohol abuse Yes 51 53.1 5.964 0.015 * No 45 46.9 Substance abuse Yes 71 74.0 20.619 0.001 * No 25 26.0 Self harm Yes 58 60.4 31.279 0.001 * No 38 39.6 Tattoo Yes 36 37.5 16.477 0.001 * No 60 62.5 Suicide attempt Yes 56 58.3 3.345 0.067 No 40 41.7 Age 23 years and under 48 50 1.042 0.307 Over 23 years 48 50 * p<0.05. APD: antisocial personality disorder Table 3. Total and subscale scores of the Buss-Perry Aggression Questionnaire of APD patients and control group Buss-Perry aggression APD Control group questionnaire (Mean [+ or -] SD) (Mean [+ or -] SD) n=96 n=97 Total score 109.07 [+ or -] 38.76 72.02 [+ or -] 15.98 Physical 27.32 [+ or -] 11.48 16.10 [+ or -] 6.04 Aggression Subscale Verbal 16.28 [+ or -] 6.01 12.15 [+ or -] 3.06 Aggression Subscale Anger Subscale 22.54 [+ or -] 7.68 14.97 [+ or -] 4.77 Hostility Subscale 26.46 [+ or -] 9.16 18.27 [+ or -] 5.06 Indirect 16.67 [+ or -] 6.73 10.53 [+ or -] 2.51 Aggression Subscale Buss-Perry aggression Statistical questionnaire analysis t/z P * Total score 8.69 (t) <0.001 * Physical -6.68 (z) <0.001 * Aggression Subscale Verbal -4.66 (z) <0.001 * Aggression Subscale Anger Subscale -6.75 (z) <0.001 * Hostility Subscale 7.69 (t) <0.001 * Indirect -5.81 (z) <0.001 * Aggression Subscale * p<0.05, (t): t test, (z): Mann-Whitney U test. APD: antisocial personality disorder; SD: standard deviation Table 4. Total and subscale scores of the Buss-Perry Aggression Questionnaire of criminal and noncriminal APD patients Buss-Perry Criminal Noncriminal aggression (Mean [+ or -] SD) (Mean [+ or -] SD) questionnaire n=49 n=47 Total score 125.76 [+ or -] 29.61 91.68 [+ or -] 39.77 Physical Aggression 32.80 [+ or -] 8.94 21.62 [+ or -] 11.12 Subscale Verbal Aggression 18.78 [+ or -] 5.18 13.68 [+ or -] 5.75 Subscale Anger Subscale 25.39 [+ or -] 6.62 19.57 [+ or -] 7.65 Hostility Subscale 29.86 [+ or -] 6.52 22.91 [+ or -] 10.19 Indirect Aggression 19.49 [+ or -] 5.86 13.53 [+ or -] 6.26 Subscale Buss-Perry Statistical analysis aggression t/z P * questionnaire Total score 4.77 (t) 0.03 * Physical Aggression -4.0 (z) <0.001 * Subscale Verbal Aggression -4.27 (z) <0.001 * Subscale Anger Subscale -3.83 (z) <0.001 * Hostility Subscale 3.99 (t) <0.001 * Indirect Aggression -4.40 (z) <0.001 * Subscale * p<0.05, (t): t test, (z): Mann-Whitney U test. APD: antisocial personality disorder; SD: standard deviation Table 5. Hormone levels of APD patients and control groups Hormones APD Control group (Mean [+ or -] SD) (Mean [+ or -] SD) n=96 n=97 Free T3 3.52 [+ or -] 0.47 3.86 [+ or -] 0.36 Free T4 1.28 [+ or -] 0.21 1.23 [+ or -] 0.14 TSH 1.72 [+ or -] 0.94 1.97 [+ or -] 1.17 Cortisol 13.73 [+ or -] 3.03 10.28 [+ or -] 4.02 Free testosterone 27.05 [+ or -] 8.20 22.95 [+ or -] 8.26 Total testosterone 631.52 [+ or -] 146.66 525.23 [+ or -] 130.08 Hormones Statistical analysis t/z p * Free T3 -5.63 (t) 0.004 * Free T4 2.10 (t) 0.044 * TSH -1.78 (z) 0.074 Cortisol 6.72 (t) 0.003 * Free testosterone 3.46 (t) 0.848 Total testosterone 5.32 (t) 0.541 * p<0.05, (t): t test, (z): Mann-Whitney U test. APD: antisocial personality disorder; SD: standard deviation Table 6. Hormone levels of criminal and noncriminal APD patients Hormones Criminal Noncriminal (Mean [+ or -] SD) (Mean [+ or -] SD) n=49 n=47 Free T3 3.60 [+ or -] 0.37 3.44 [+ or -] 0.55 Free T4 1.31 [+ or -] 0.26 1.25 [+ or -] 0.13 TSH 1.72 [+ or -] 0.79 1.72 [+ or -] 1.08 Cortisol 13.94 [+ or -] 3.21 13.52 [+ or -] 2.85 Free testosterone 26.41 [+ or -] 8.81 27.71 [+ or -] 7.56 Total testosterone 628.97 [+ or -] 174.12 634.18 [+ or -] 113.01 Hormones Statistical analysis t/z p * Free T3 1.62 (t) 0.002 * Free T4 1.44 (t) 0.112 TSH -0.51 (z) 0.610 Cortisol 0.67 (t) 0.368 Free testosterone -0.77 (t) 0.296 Total testosterone -0.1 (t) 0.132 * p<0.05, (t): t test, (z): Mann-Whitney U test. APD: antisocial personality disorder; SD: standard deviation
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|Title Annotation:||Research Article|
|Author:||Evrensel, Alper; Unsalver, Baris Onen; Ozsahin, Aytekin|
|Publication:||Archives of Neuropsychiatry|
|Date:||Jun 1, 2016|
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